Provider Demographics
NPI:1710039599
Name:PANDURA CORPORATION
Entity Type:Organization
Organization Name:PANDURA CORPORATION
Other - Org Name:P&A MEDICAL BILLING SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:PANDURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-336-0771
Mailing Address - Street 1:231 H ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-2942
Mailing Address - Country:US
Mailing Address - Phone:661-336-0771
Mailing Address - Fax:661-336-0783
Practice Address - Street 1:231 H ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-2942
Practice Address - Country:US
Practice Address - Phone:661-336-0771
Practice Address - Fax:661-336-0783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF1CMedicaid
CAF1CMedicaid