Provider Demographics
NPI:1588854723
Name:PANDYA, SIMA CHIRAG (DPM)
Entity Type:Individual
Prefix:DR
First Name:SIMA
Middle Name:CHIRAG
Last Name:PANDYA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4456 BLACK AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6147
Mailing Address - Country:US
Mailing Address - Phone:925-416-0990
Mailing Address - Fax:925-416-1843
Practice Address - Street 1:4456 BLACK AVE STE 100
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6147
Practice Address - Country:US
Practice Address - Phone:925-416-0990
Practice Address - Fax:925-416-1843
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4873213E00000X
CA4873213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist