Provider Demographics
NPI:1790863306
Name:PANHWAR, SIERA (MD)
Entity Type:Individual
Prefix:
First Name:SIERA
Middle Name:
Last Name:PANHWAR
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 1:25 BRISA FRESCA
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-3315
Mailing Address - Country:US
Mailing Address - Phone:949-459-1716
Mailing Address - Fax:
Practice Address - Street 1:407 W IMPERIAL HWY # H171
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-4832
Practice Address - Country:US
Practice Address - Phone:562-365-3540
Practice Address - Fax:562-365-3532
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97303207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine