MEDICARE: MANIKA PANDEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A37220	CA

General Provider Information

NPI Number	:	1275690653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANIKA PANDEY MD

Provider Business Mailing Address
First Line	:	1166 K ST
Second Line	:
City	:	BRAWLEY
State	:	CA
Zip	:	92227-2737
Country	:	US
Telephone Number	:	760-344-9951
Fax Number	:

Provider Business Practice Location Address
First Line	:	91275 66TH AVE
Second Line	:	500
City	:	MECCA
State	:	CA
Zip	:	92254
Country	:	US
Telephone Number	:	760-396-1249
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	12/20/2011

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