Provider Demographics
NPI:1144493131
Name:PANOUSSI, FERDINAND J (DO)
Entity type:Individual
Prefix:DR
First Name:FERDINAND
Middle Name:J
Last Name:PANOUSSI
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1600 W AVENUE J
Mailing Address - Street 2:AVH, COGENTHMG, ROOM # 296, ATTEN: DR. PANOUSSI
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2814
Mailing Address - Country:US
Mailing Address - Phone:661-726-6254
Mailing Address - Fax:661-726-6256
Practice Address - Street 1:1600 W AVENUE J
Practice Address - Street 2:AVH, COGENTHMG, ROOM # 296, ATTEN: DR. PANOUSSI
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2814
Practice Address - Country:US
Practice Address - Phone:661-726-6254
Practice Address - Fax:661-726-6256
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2013-08-20
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Provider Licenses
StateLicense IDTaxonomies
CA20A10970207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine