Provider Demographics
NPI:1437187994
Name:KARAN, PANKAJ KUMAR (MD INTERNAL MEDICINE)
Entity Type:Individual
Prefix:DR
First Name:PANKAJ
Middle Name:KUMAR
Last Name:KARAN
Suffix:
Gender:M
Credentials:MD INTERNAL MEDICINE
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1119
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:CA
Mailing Address - Zip Code:93271-1119
Mailing Address - Country:US
Mailing Address - Phone:714-749-3044
Mailing Address - Fax:949-862-8060
Practice Address - Street 1:42215 BLACK OAK DR
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:CA
Practice Address - Zip Code:93271-9796
Practice Address - Country:US
Practice Address - Phone:714-749-3044
Practice Address - Fax:949-862-8060
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA54018207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8911735Medicaid
CA8811735Medicaid
CAG52815Medicare UPIN