Individual
JOSE L. PANTOJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5750 DOWNEY AVE, SUITE 202, LAKEWOOD, CA 90712-1405
(562) 634-4939
(562) 634-5809
Mailing address
PO BOX 666, ARTESIA, CA 90702-0666
(562) 634-4939
(562) 634-5809
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C43031
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C430310
—
CA
01
—
C43031
MEDICAL LICENSE
CA
Enumeration date
06/24/2006
Last updated
11/13/2007
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