Manika Pandey, MD

Individual provider Active NPI Family Medicine Physician · Mecca, CA

NPI 1275690653 · NPPES record last updated Dec 20, 2011

Key facts

NPI
1275690653
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
A37220 (CA)
Practice address
91275 66TH Ave
500
Mecca, CA 92254
Phone
(760) 396-1249
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20130612000157 CA Order and Referring Only - Family Practice
Practitioner - Family Practice
3173610011

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas de Salud del Pueblo Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A37220 CA Yes

Addresses

Primary practice location

91275 66TH Ave
500
Mecca, CA 92254

Mailing address

1166 K St
Brawley, CA 92227-2737
Phone (760) 344-9951

Other providers in Mecca, CA

All providers in Mecca, CA · Family Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.