Jenny S Pan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A43079 Issued in CA

Practice address

1045 Atlantic Ave
Suite 605
Long Beach, CA 90813-3408

Phone

(562) 901-6767

Fax

(562) 901-6777

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mrs. Sheue Ching Chen Pan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1760550420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4673 CANDLEBERRY AVE",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907403033",
            "telephone_number": "714-345-8729",
            "fax_number": "714-540-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 ATLANTIC AVE",
            "address_2": "SUITE 605",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133408",
            "telephone_number": "562-901-6767",
            "fax_number": "562-901-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "JENNY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A43079",
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A43079",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A430790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHEUE",
            "last_name": "CHEN PAN",
            "middle_name": "CHING",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pamela E. Dunn Chiropractic, Apc (Dunn Family Chiropractic)
• Pan and Hsu Pediatrics
• Alexandria Mony Pan, AMFT
• Chris Wei-Sen Pan, MD. MBA. MS.
• Jacqueline Pan
• Panacea Healthcare Medical Group Inc
• Panacea Healthcare Medical Group, Inc.
• Mahendra J Panchal, MD
• Jahnvi Pancholi
• Daniel Panduro

• Pediatrics Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.