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NPI Code Detail

MEDICARE: ANABELLA PASCUCCI M.D.

MEDICARE: ANABELLA PASCUCCI 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
1207N00000XDermatology PhysicianA113352CA

General Provider Information

NPI Number : 1558641936
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANABELLA PASCUCCI M.D.
Provider Business Mailing Address
First Line : 5767 W CENTURY BLVD STE 400
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 514 N PROSPECT AVE STE 103
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90277-3037
Country : US
Telephone Number : 310-937-8555
Fax Number : 310-937-8556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2011
Last Update Date : 11/22/2019

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