Bol Gach Pan

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

D06464178 Issued in AZ

Practice address

9250 N 75TH Ave Lot 48
Peoria, AZ 85345-6634

Phone

(602) 481-0911

NPI assigned

Oct 4, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1336929488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8050 N 19TH AVE # 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215101",
            "telephone_number": "602-481-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 N 75TH AVE LOT 48",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853456634",
            "telephone_number": "602-481-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "BOL",
        "middle_name": "GACH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "AZ",
            "license": "D06464178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Paladino, MPT
• Colleen Palko, L.M.T.
• Kelsey Jordan Palmer, OD
• Palo Verde Family Medicine PLLC
• Palo Verde Hematology Oncology LTD
• Kaveh Panahi, DPM
• Panda Medical Associates, LLC
• Lea Pannella, NP
• Paul Anthony Pannozzo, MD
• Michael Panopio, PT, DPT

• Non-emergency Medical Transport (VAN) in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Non-emergency Medical Transport (VAN) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.