Individual
DR. AJAY PANCHOLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2330 UTAH AVE, EL SEGUNDO, CA 90245-4817
(424) 290-8004
Mailing address
2330 UTAH AVE, EL SEGUNDO, CA 90245-4817
(424) 290-8004
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
ME89899
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME89899
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118717
—
AL
05
—
271833200
—
FL
Enumeration date
03/22/2006
Last updated
01/21/2025
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