Provider Demographics
NPI:1972639508
Name:MCDANIEL, PANDORA F (NP)
Entity Type:Individual
Prefix:MS
First Name:PANDORA
Middle Name:F
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1670 E 120TH ST
Mailing Address - Street 2:MODULE B
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90059-3026
Mailing Address - Country:US
Mailing Address - Phone:424-338-1276
Mailing Address - Fax:310-223-0192
Practice Address - Street 1:12021 WILMINGTON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059-3019
Practice Address - Country:US
Practice Address - Phone:310-668-4515
Practice Address - Fax:310-763-8909
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARN383138363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner