Basic Information
| Provider Information | |||||||||
| NPI: | 1265644629 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAGGA | ||||||||
| FirstName: | PAVANDEEP | ||||||||
| MiddleName: | SINGH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 28160 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937298160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594360871 | ||||||||
| FaxNumber: | 5594365221 | ||||||||
| Practice Location | |||||||||
| Address1: | 450 E ROMIE LN | ||||||||
| Address2: | DEPARTMENT OF ANESTHESIA | ||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939014029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162860558 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2007 | ||||||||
| LastUpdateDate: | 06/01/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | MT188671 | PA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207L00000X | A112605 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP3000X | A112605 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pediatric Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 23-2290323 | 01 | PA | AEMC | OTHER |