Provider Demographics
NPI:1285734749
Name:PANASCI, ANTHONY D (MD FACS RVT)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:D
Last Name:PANASCI
Suffix:
Gender:M
Credentials:MD FACS RVT
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Mailing Address - Street 1:25880 TOURNAMENT RD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355
Mailing Address - Country:US
Mailing Address - Phone:661-254-0720
Mailing Address - Fax:661-254-0860
Practice Address - Street 1:25880 TOURNAMENT RD
Practice Address - Street 2:SUITE #222
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355
Practice Address - Country:US
Practice Address - Phone:661-254-0720
Practice Address - Fax:661-254-0860
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG390292086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G390290Medicaid
CAG39029Medicare PIN
CA00G390290Medicaid