MEDICARE: ANASTACIO C PINZON M.D. INC

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	207RG0100X	Gastroenterology Physician	A328250	CA

General Provider Information

NPI Number	:	1659530749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANASTACIO C PINZON M.D. INC

Provider Business Mailing Address
First Line	:	2252 BEVERLY BLVD
Second Line	:	STE 101
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2235
Country	:	US
Telephone Number	:	213-487-6157
Fax Number	:	213-487-1177

Provider Business Practice Location Address
First Line	:	2252 BEVERLY BLVD
Second Line	:	STE 101
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2235
Country	:	US
Telephone Number	:	213-487-6157
Fax Number	:	213-487-1177

Authorized Official
Title or Position	:	OFFICE ADMINISTRATOR
Name	:	DELINIA ALFARO PINZON
Credential	:
Telephone Number	:	213-487-6751

Provider Enumeration Date	:	06/04/2008
Last Update Date	:	01/18/2010

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