Healthcare Provider Details
I. General information
NPI: 1154597870
Provider Name (Legal Business Name): PAM K JANDA M D INC A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/02/2008
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7078 N MAPLE AVE
FRESNO CA
93720-8023
US
IV. Provider business mailing address
7078 N MAPLE AVE STE 101
FRESNO CA
93720-8023
US
V. Phone/Fax
- Phone: 559-449-8200
- Fax: 559-449-1227
- Phone: 559-449-8200
- Fax: 559-449-1227
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PAM
K
JANDA
Title or Position: OWNER
Credential: MD
Phone: 559-449-8200