Provider Demographics
NPI:1619932498
Name:MISA, SHIRLEY PANGAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:PANGAN
Last Name:MISA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6926 VERDE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-4640
Mailing Address - Country:US
Mailing Address - Phone:310-377-6768
Mailing Address - Fax:
Practice Address - Street 1:4101 TORRANCE BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4607
Practice Address - Country:US
Practice Address - Phone:310-543-6791
Practice Address - Fax:310-792-7671
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA312022080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine