Healthcare Provider Details

I. General information

NPI: 1073319349
Provider Name (Legal Business Name): PANDIA MEDICAL GROUP, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1257 ELKO DR
SUNNYVALE CA
94089-2214
US

IV. Provider business mailing address

411 LOS NINOS WAY
LOS ALTOS CA
94022-1726
US

V. Phone/Fax

Practice location:
  • Phone: 650-437-1213
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SOPHIA YEN
Title or Position: CEO/PRESIDENT
Credential: MD
Phone: 650-437-1213