=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851370480
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHVIN C PANDYA M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/12/2006
-----------------------------------------------------
Last Update Date | 08/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 407 WEST LINE ST. SUITE #7
-----------------------------------------------------
City | BISHOP
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93514
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-873-3561
-----------------------------------------------------
Fax | 760-872-3197
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 37 SAINT MICHAEL
-----------------------------------------------------
City | MONARCH BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92629
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-937-2347
-----------------------------------------------------
Fax | 760-872-3197
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | A45684
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------