Provider Demographics
NPI:1497773840
Name:PANORAMA CITY MEDICAL CENTER,INC
Entity Type:Organization
Organization Name:PANORAMA CITY MEDICAL CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MING CHANG
Authorized Official - Middle Name:
Authorized Official - Last Name:HSU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-994-8900
Mailing Address - Street 1:8215 VAN NUYS BLVD
Mailing Address - Street 2:#311
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4810
Mailing Address - Country:US
Mailing Address - Phone:818-994-8900
Mailing Address - Fax:818-994-2353
Practice Address - Street 1:8215 VAN NUYS BLVD
Practice Address - Street 2:#311
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4810
Practice Address - Country:US
Practice Address - Phone:818-994-8900
Practice Address - Fax:818-994-2353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18557Medicare ID - Type Unspecified