Provider Demographics
NPI:1932315579
Name:PAN, HONGYU (MD)
Entity Type:Individual
Prefix:
First Name:HONGYU
Middle Name:
Last Name:PAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2574 SAN BRUNO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94134-1505
Mailing Address - Country:US
Mailing Address - Phone:415-391-9686
Mailing Address - Fax:415-352-5063
Practice Address - Street 1:2574 SAN BRUNO AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94134-1505
Practice Address - Country:US
Practice Address - Phone:415-391-9686
Practice Address - Fax:415-352-5063
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107088207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine