Provider Demographics
NPI:1063258572
Name:CROSS, RANZEL PANGOS (MBA)
Entity type:Individual
Prefix:
First Name:RANZEL
Middle Name:PANGOS
Last Name:CROSS
Suffix:
Gender:F
Credentials:MBA
Other - Prefix:
Other - First Name:RONNIE
Other - Middle Name:
Other - Last Name:CROSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:840 E MANRESA DR
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-6861
Mailing Address - Country:US
Mailing Address - Phone:626-513-6143
Mailing Address - Fax:
Practice Address - Street 1:135 N PARK VIEW ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-5215
Practice Address - Country:US
Practice Address - Phone:818-271-0901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker