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NPI Code Detail

MEDICARE: DR. AMRITPAL S PANNU MD

MEDICARE: DR. AMRITPAL S PANNU MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianA62711CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306837927
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMRITPAL S PANNU MD
Provider Business Mailing Address
First Line : 2339 W CLEVELAND AVE
Second Line : #103
City : MADERA
State : CA
Zip : 93637-8764
Country : US
Telephone Number : 559-673-8055
Fax Number : 559-673-0389
Provider Business Practice Location Address
First Line : 2339 CLEVELAND AVE
Second Line : #101
City : MADERA
State : CA
Zip : 93637
Country : US
Telephone Number : 559-673-8055
Fax Number : 559-673-0389
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 01/27/2010

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