Individual
PHILLIP LYLE PANGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, NP
Contact information
Practice address
3330 LOMITA BLVD, TORRANCE, CA 90505-5002
(310) 325-9110
Mailing address
16416 FLALLON AVE, NORWALK, CA 90650-7027
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
833834
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
NP95009782
CA
Other
Enumeration date
09/07/2018
Last updated
09/24/2019
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