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General NPI Number Information
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NPI Number | 1255461083
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Entity Type | Organization
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Legal Business Name | SANJOG A. PANGARKAR, M.D.
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 06/28/2013
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Provider Practice Location Address
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Address Line | 100 UCLA MEDICAL PLZ STE. 760
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City | LOS ANGELES
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State | CA
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Zip | 90095-0001
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Country | US
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Telephone | 310-794-7246
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 60790
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City | PASADENA
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State | CA
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Zip | 91116-6790
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Country | US
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Telephone | 626-795-6596
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Fax | 626-795-8247
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Authorized Official
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Title or Position | OWNER
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Name | DR. SANJOG A. PANGARKAR
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Credential | M.D.
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Telephone | 310-794-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | A83673
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License Number State | CA
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