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NPI Code Detail

MEDICARE: GLENN PANZER M.D

MEDICARE: GLENN PANZER M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianG86525CA

General Provider Information

NPI Number : 1154351088
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLENN PANZER M.D
Provider Business Mailing Address
First Line : 500 LA TERRAZA BLVD SUITE 130
Second Line :
City : ESCONDIDO
State : CA
Zip : 92025-3875
Country : US
Telephone Number : 760-737-2050
Fax Number : 760-796-3781
Provider Business Practice Location Address
First Line : 425 N DATE ST
Second Line :
City : ESCONDIDO
State : CA
Zip : 92025-3413
Country : US
Telephone Number : 760-739-2371
Fax Number : 760-739-2376
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2006
Last Update Date : 05/21/2018

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Directions to “ GLENN PANZER M.D” Practice Location

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