Provider Demographics
NPI:1659773349
Name:PACIFIC HEART AND LUNG SURGEONS INC
Entity Type:Organization
Organization Name:PACIFIC HEART AND LUNG SURGEONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:PANAGIOTIDES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-531-0019
Mailing Address - Street 1:3650 SOUTH ST
Mailing Address - Street 2:STE 206
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-1502
Mailing Address - Country:US
Mailing Address - Phone:562-531-0019
Mailing Address - Fax:562-531-0032
Practice Address - Street 1:3650 SOUTH ST
Practice Address - Street 2:STE 206
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-1502
Practice Address - Country:US
Practice Address - Phone:562-531-0019
Practice Address - Fax:562-531-0032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty