Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | A96372 | CA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | A96372 | CA |
NPI | 1245421445 |
---|---|
Provider Name | Dr. Michael Scott Panutich |
First Address | Newport Beach, CA 92663 |
Second Address | Newport Beach, CA 92663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2007 |
Last Update Date | 18/02/2020 |