Provider Demographics
NPI:1518522341
Name:PANDIAN, ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:PANDIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SBCH, MEDICAL EDUCATION
Mailing Address - Street 2:400 W PUEBLO STREET
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93015
Mailing Address - Country:US
Mailing Address - Phone:805-569-7315
Mailing Address - Fax:805-569-8358
Practice Address - Street 1:SBCH, MEDICAL EDUCATION
Practice Address - Street 2:400 W PUEBLO STREET
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93015
Practice Address - Country:US
Practice Address - Phone:805-569-7315
Practice Address - Fax:805-569-8358
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1787641835P0018X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program