Provider Demographics
NPI:1457461725
Name:PANTERA, RICHARD LEO (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEO
Last Name:PANTERA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5344 W PROSPECT CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-9274
Mailing Address - Country:US
Mailing Address - Phone:559-303-6929
Mailing Address - Fax:559-625-1064
Practice Address - Street 1:107 N HALL ST STE A
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5850
Practice Address - Country:US
Practice Address - Phone:559-429-4781
Practice Address - Fax:559-623-9745
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2025-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG364662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G364660Medicare PIN