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General NPI Number Information
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NPI Number | 1497011316
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Entity Type | Individual
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Provider Name | TEJAL GAURANG PANDYA MD
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Gender | Female
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Dates
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Enumeration Date | 04/04/2012
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 555 W PUTNAM AVE
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City | PORTERVILLE
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State | CA
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Zip | 93257-3286
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Country | US
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Telephone | 559-782-8533
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Fax | 559-782-8544
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Provider Business Mailing Address
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Address Line | 555 W PUTNAM AVE
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City | PORTERVILLE
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State | CA
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Zip | 93257-3286
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Country | US
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Telephone | 559-782-8533
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Fax | 559-782-8544
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A128754
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD61157645
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License Number State | WA
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