Basic Information
Provider Information
NPI: 1437230877
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAMMI
FirstName: NEESHA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2637 SHADELANDS DR
Address2:  
City: WALNUT CREEK
State: CA
PostalCode: 945982512
CountryCode: US
TelephoneNumber: 9259309978
FaxNumber: 9259309663
Practice Location
Address1: 2637 SHADELANDS DR
Address2:  
City: WALNUT CREEK
State: CA
PostalCode: 945982512
CountryCode: US
TelephoneNumber: 9259309978
FaxNumber: 9259309663
Other Information
ProviderEnumerationDate: 10/18/2006
LastUpdateDate: 02/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XA79090CAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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