Individual provider Active NPI

William Clifford Pannell III, MD

  • Orthopaedic Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1972913762
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A132633 Issued in CA
Practice address
1520 San Pablo St Ste 2000
Los Angeles, CA 90033-5322
Phone
(323) 442-5860
NPI assigned
May 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A132633 CA Primary

Addresses

Primary practice location

1520 San Pablo St Ste 2000
Los Angeles, CA 90033-5322

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151019002042 CA Practitioner - Orthopedic Surgery 8426367277 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A132633CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc Orthopaedic Surgery CurrentSince Jul 1, 2019 Accepting new patients
Usc Care Medical Group, Inc Orthopaedic Surgery CurrentSince Jul 1, 2019 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1520 San Pablo St
Ste 2000
Los Angeles, CA 90033
Phone (323) 442-5830

1520 San Pablo St
#3900
Los Angeles, CA 90033

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1972913762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST STE 2000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335322",
            "telephone_number": "323-442-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNELL",
        "first_name": "WILLIAM",
        "middle_name": "CLIFFORD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-01",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A132633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.