Healthcare Provider Details

I. General information

NPI: 1376337162
Provider Name (Legal Business Name): BISHWA PANDYA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1563 MISSION ST
SAN FRANCISCO CA
94103-2543
US

IV. Provider business mailing address

1563 MISSION ST
SAN FRANCISCO CA
94103-2543
US

V. Phone/Fax

Practice location:
  • Phone: 415-746-1940
  • Fax: 415-746-1941
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2023050131
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: