MEDICARE: DR. GEORGE PAN 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
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	A132921	CA
2	208VP0000X	Pain Medicine Physician	A132921	CA

General Provider Information

NPI Number	:	1295026417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE PAN M.D.

Provider Business Mailing Address
First Line	:	11500 W OLYMPIC BLVD STE 502
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1528
Country	:	US
Telephone Number	:	424-300-8217
Fax Number	:	310-861-0087

Provider Business Practice Location Address
First Line	:	11500 W OLYMPIC BLVD STE 502
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1528
Country	:	US
Telephone Number	:	424-300-8217
Fax Number	:	310-861-0087

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2011
Last Update Date	:	04/14/2026

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Directions to “ DR. GEORGE PAN M.D.” Practice Location

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