Provider Demographics
NPI:1376830950
Name:PANTER, BARRY (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:PANTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10100 EMPYREAN WAY
Mailing Address - Street 2:103
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-3824
Mailing Address - Country:US
Mailing Address - Phone:310-286-2294
Mailing Address - Fax:323-874-5003
Practice Address - Street 1:10100 EMPYREAN WAY
Practice Address - Street 2:103
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-3824
Practice Address - Country:US
Practice Address - Phone:310-286-2294
Practice Address - Fax:323-874-5003
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA196762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry