Provider Demographics
NPI:1912994237
Name:JANDA, PAM K (MD)
Entity Type:Individual
Prefix:DR
First Name:PAM
Middle Name:K
Last Name:JANDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7078 N. MAPLE AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-8023
Mailing Address - Country:US
Mailing Address - Phone:559-449-8200
Mailing Address - Fax:559-449-1227
Practice Address - Street 1:7078 N. MAPLE AVE
Practice Address - Street 2:STE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-8023
Practice Address - Country:US
Practice Address - Phone:559-449-8200
Practice Address - Fax:559-449-1227
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2014-06-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA37511207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A375110Medicaid
CA00A375110Medicare PIN