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NPI Code Detail

MEDICARE: MRS. ANA BERTHA PANTOJA M.D.

MEDICARE: MRS. ANA BERTHA PANTOJA 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 PhysicianA91066CA

General Provider Information

NPI Number : 1164593877
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANA BERTHA PANTOJA M.D.
Provider Business Mailing Address
First Line : 1300 S SUNSET AVE
Second Line :
City : WEST COVINA
State : CA
Zip : 91790-3342
Country : US
Telephone Number : 626-960-6999
Fax Number : 626-960-5246
Provider Business Practice Location Address
First Line : 1300 S SUNSET AVE
Second Line :
City : WEST COVINA
State : CA
Zip : 91790-3342
Country : US
Telephone Number : 626-960-6999
Fax Number : 626-960-5246
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 12/02/2016

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Directions to “ MRS. ANA BERTHA PANTOJA M.D.” Practice Location

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