Individual
JASON PANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24712 CLARINGTON DR, LAGUNA HILLS, CA 92653-4305
(949) 770-1122
(949) 770-9189
Mailing address
PO BOX 8047, LA CRESCENTA, CA 91224-0047
(949) 770-1122
(949) 770-9189
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A69884
CA
207RN0300X
Nephrology Physician
Primary
A69884
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A698840
—
CA
Enumeration date
11/13/2006
Last updated
04/04/2013
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