Organization Active NPI

Kamaldeep Panach, M.D., Inc.

  • Internal Medicine Physician
  • Menifee, CA
National Provider Identifier
1386301687
Registry record updated Nov 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
KAMALDEEP PANACH, M.D., INC.
Practice address
29826 Haun Rd Ste 302
Menifee, CA 92586-6547
Phone
(951) 672-1911
NPI assigned
Nov 21, 2021
Last updated
Nov 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2021

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

Authorized official

Name
Kamaldeep PanachNPI 1043501174
Title
President
Phone
(559) 301-9209

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

29826 Haun Rd Ste 302
Menifee, CA 92586-6547

Mailing address

10260 W Shields Ave
Fresno, CA 93723-9612
Phone (559) 301-9209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220119001893 CA Part B Supplier - Clinic/Group Practice 2860884103 Receives reassigned benefits from 2 practitioners
Practice locations: Menifee, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1637452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637452800000",
    "number": "1386301687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10260 W SHIELDS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937239612",
            "telephone_number": "559-301-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29826 HAUN RD STE 302",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925866547",
            "telephone_number": "951-672-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAMALDEEP PANACH, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-21",
        "last_updated": "2021-11-21",
        "certification_date": "2021-11-21",
        "status": "A",
        "authorized_official_last_name": "PANACH",
        "authorized_official_first_name": "KAMALDEEP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-301-9209"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menifee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.