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General NPI Number Information
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NPI Number | 1306837927
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Entity Type | Individual
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Provider Name | AMRITPAL S PANNU MD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 2339 CLEVELAND AVE #101
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City | MADERA
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State | CA
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Zip | 93637
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Country | US
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Telephone | 559-673-8055
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Fax | 559-673-0389
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Provider Business Mailing Address
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Address Line | 2339 W CLEVELAND AVE #103
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City | MADERA
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State | CA
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Zip | 93637-8764
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Country | US
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Telephone | 559-673-8055
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Fax | 559-673-0389
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A62711
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License Number State | CA
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