Individual
DR. JENNY S PAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1045 ATLANTIC AVE, SUITE 605, LONG BEACH, CA 90813-3408
(562) 901-6767
(562) 901-6777
Mailing address
4673 CANDLEBERRY AVE, SEAL BEACH, CA 90740-3033
(714) 345-8729
(714) 540-0311
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A43079
CA
2080N0001X
Neonatal-Perinatal Medicine Physician
A43079
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A430790
—
CA
Enumeration date
12/01/2006
Last updated
11/09/2012
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