Individual provider Active NPI

Braj Bhushan Pandey, MD

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1336158138
Registry record updated May 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A048371 Issued in CA
Practice address
3350 La Jolla Village Dr Mail Code # 111N
San Diego, CA 92161-0001
Phone
(858) 552-8585
Fax
(858) 642-6273
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A048371 CA Primary

Addresses

Primary practice location

3350 La Jolla Village Dr Mail Code # 111N
San Diego, CA 92161-0001

Mailing address

VA Medical Ctr
3350 La Jolla Village Drive
San Diego, CA 92161-0001
Phone (858) 552-8585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A048371CAMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369180800000",
    "number": "1336158138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "VA MEDICAL CTR",
            "address_2": "3350 LA JOLLA VILLAGE DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610001",
            "telephone_number": "858-552-8585",
            "fax_number": "858-642-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR MAIL CODE # 111N",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610001",
            "telephone_number": "858-552-8585",
            "fax_number": "858-642-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDEY",
        "first_name": "BRAJ",
        "middle_name": "BHUSHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2013-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A048371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.