Individual
DR. RICHARD S PANUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1520 SAN PABLO ST, SUITE 1000, LOS ANGELES, CA 90033-5310
(323) 442-5100
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-1309
(323) 442-5100
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
C 33656
CA
207RR0500X
Rheumatology Physician
MA052705
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902846306
GROUP NPI
CA
01
—
GR0100430
GROUP MEDICAL
CA
01
—
W18762
GROUP MEDICARE
CA
Enumeration date
06/23/2006
Last updated
08/19/2020
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