Provider Demographics
NPI:1881862845
Name:PANDY, LIZANDER CAINAP (DO)
Entity Type:Individual
Prefix:DR
First Name:LIZANDER
Middle Name:CAINAP
Last Name:PANDY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31001 RANCHO VIEJO RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-8704
Mailing Address - Country:US
Mailing Address - Phone:949-661-9600
Mailing Address - Fax:949-443-6200
Practice Address - Street 1:31001 RANCHO VIEJO RD STE 200
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-8704
Practice Address - Country:US
Practice Address - Phone:949-661-9600
Practice Address - Fax:949-443-6200
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9809207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB224513Medicare PIN