Healthcare Provider Details

I. General information

NPI: 1881874683
Provider Name (Legal Business Name): PANSOPHY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CORPORATE PLACE SUITE D
VALLEJO CA
94590
US

IV. Provider business mailing address

3479 WOODSIDE TER
FREMONT CA
94539-8073
US

V. Phone/Fax

Practice location:
  • Phone: 707-642-6811
  • Fax: 707-642-6917
Mailing address:
  • Phone: 707-642-6811
  • Fax: 707-642-6917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. MANJU ASTHANA
Title or Position: SECRETARY
Credential:
Phone: 510-709-8785