Healthcare Provider Details

I. General information

NPI: 1023122918
Provider Name (Legal Business Name): KIRAN PANDEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 11/22/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9333 IMPERIAL HWY DOWNEY
DOWNEY CA
90242-2812
US

IV. Provider business mailing address

9333 IMPERIAL HWY
DOWNEY CA
90242-2812
US

V. Phone/Fax

Practice location:
  • Phone: 877-608-0044
  • Fax:
Mailing address:
  • Phone: 877-608-0044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number131567
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: