Basic Information
| Provider Information | |||||||||
| NPI: | 1447577952 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PANDYA | ||||||||
| FirstName: | NIKHIL | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3129 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905103129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3107923914 | ||||||||
| FaxNumber: | 8558984055 | ||||||||
| Practice Location | |||||||||
| Address1: | 15910 VENTURA BLVD | ||||||||
| Address2: | SUITE 1502 | ||||||||
| City: | ENCINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914362802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8187289877 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2010 | ||||||||
| LastUpdateDate: | 03/05/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 256441 | NY | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 20A12384 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.