Andre Panossian MD a Professional Corporation

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A76052 Issued in CA

Legal business name

ANDRE PANOSSIAN MD A PROFESSIONAL CORPORATION

Practice address

39 Congress St Ste 402
Pasadena, CA 91105-3024

Phone

(800) 958-3778

Fax

(800) 958-3778

NPI assigned

Aug 29, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andre Panossian, MD

Title

Owner

Phone

(800) 958-3778

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569715200000",
    "number": "1679973366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 CONGRESS ST STE 402",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053024",
            "telephone_number": "800-958-3778",
            "fax_number": "800-958-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 CONGRESS ST STE 402",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053024",
            "telephone_number": "800-958-3778",
            "fax_number": "800-958-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDRE PANOSSIAN MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-29",
        "last_updated": "2019-09-29",
        "status": "A",
        "authorized_official_last_name": "PANOSSIAN",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-958-3778",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A76052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A760520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanya Naomi Andino, M.S.
• Daniela Sandra Andrade
• Evelyn Andrade
• Jennifer Andrade
• Valerie Andrade
• Caroline Andre
• Andrea Davis, PH.D., Clinical Psychology, Inc.
• Odalys Daniela Andres
• Andrew Cotham Physical Therapy P.C.
• Andrew H.R. Singleton, M.D., Inc

• Plastic Surgery Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.