Provider Demographics
NPI:1609614650
Name:PANGAN, CHRISTINA QUIJANO (NP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:QUIJANO
Last Name:PANGAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8899 LA MANGA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6022
Mailing Address - Country:US
Mailing Address - Phone:808-393-9283
Mailing Address - Fax:
Practice Address - Street 1:8899 LA MANGA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-6022
Practice Address - Country:US
Practice Address - Phone:808-393-9283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV879969207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine