Provider Demographics
NPI:1518280619
Name:LOUIS PARDINI, M.D., APC
Entity Type:Organization
Organization Name:LOUIS PARDINI, M.D., APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PARDINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-432-1520
Mailing Address - Street 1:1095 E WARNER AVE
Mailing Address - Street 2:102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-4000
Mailing Address - Country:US
Mailing Address - Phone:559-432-1520
Mailing Address - Fax:559-432-5062
Practice Address - Street 1:1095 E WARNER AVE
Practice Address - Street 2:102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-4000
Practice Address - Country:US
Practice Address - Phone:559-432-1520
Practice Address - Fax:559-432-5062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA16574207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA543620707Medicaid
CA543620707Medicaid
CAA20592Medicare UPIN