MEDICARE: RICHARD LEO PANTERA 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
1	2084N0400X	Neurology Physician	G36466	CA

General Provider Information

NPI Number	:	1457461725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD LEO PANTERA MD

Provider Business Mailing Address
First Line	:	5344 W PROSPECT CT
Second Line	:
City	:	VISALIA
State	:	CA
Zip	:	93291-9274
Country	:	US
Telephone Number	:	559-303-6929
Fax Number	:	559-625-1064

Provider Business Practice Location Address
First Line	:	107 N HALL ST STE A
Second Line	:
City	:	VISALIA
State	:	CA
Zip	:	93291-5850
Country	:	US
Telephone Number	:	559-429-4781
Fax Number	:	559-623-9745

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	05/14/2025

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