Provider Demographics
NPI:1033101100
Name:PANDOL, ERIN PARKER (MPT, OCS)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:PARKER
Last Name:PANDOL
Suffix:
Gender:F
Credentials:MPT, OCS
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:K
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT, OCS
Mailing Address - Street 1:1701 S LEXINGTON ST
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-9200
Mailing Address - Country:US
Mailing Address - Phone:661-720-2660
Mailing Address - Fax:661-720-2661
Practice Address - Street 1:1701 S LEXINGTON ST
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-9200
Practice Address - Country:US
Practice Address - Phone:661-720-2660
Practice Address - Fax:661-720-2661
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26763225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00113611OtherRAILROAD MEDICARE PTAN
CAZZZ21295ZOtherMEDICARE GROUP PTAN
CA0PT267631OtherMEDICARE INDIVIDUAL PTAN
CA0PT267631OtherMEDICARE INDIVIDUAL PTAN