Provider Demographics
NPI:1740560903
Name:PANA, EDMUND RAY HERNANDEZ (MD)
Entity Type:Individual
Prefix:DR
First Name:EDMUND RAY
Middle Name:HERNANDEZ
Last Name:PANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2302
Mailing Address - Country:US
Mailing Address - Phone:855-206-6764
Mailing Address - Fax:949-923-3575
Practice Address - Street 1:11 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2302
Practice Address - Country:US
Practice Address - Phone:855-206-6764
Practice Address - Fax:949-923-3575
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA151378207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine