Charles Vincent Panadero, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

A77796 Issued in CA

Practice address

4250 Auburn Blvd
Sacramento, CA 95841-4100

Phone

(916) 489-3336

NPI assigned

Dec 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1902881808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1956",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956777956",
            "telephone_number": "916-761-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 AUBURN BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958414100",
            "telephone_number": "916-489-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANADERO",
        "first_name": "CHARLES",
        "middle_name": "VINCENT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A77796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A777960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Panacea, Inc.
• Panacea, Inc.
• Panacea, Inc.
• Panacea, Inc.
• Panacea, Inc.
• Brandon Anthony Panariello, MHRS
• Rima R Panchal, PHARMD
• Linda Pancho, M.D.
• Vijai Pandey
• Pritam Pandit

• Child & Adolescent Psychiatry Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.