Provider Demographics
NPI:1760542203
Name:PANDYA, NIRAV K (MD)
Entity Type:Individual
Prefix:
First Name:NIRAV
Middle Name:K
Last Name:PANDYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:747 52ND STREET
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1809
Mailing Address - Country:US
Mailing Address - Phone:510-428-3238
Mailing Address - Fax:510-601-3904
Practice Address - Street 1:747 52ND STREET
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1809
Practice Address - Country:US
Practice Address - Phone:510-428-3238
Practice Address - Fax:510-601-3904
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA110499207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery