Individual
AUDREY Y. PAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3160 FOLSOM BLVD, SACRAMENTO, CA 95816-5219
(916) 733-5336
(916) 733-5385
Mailing address
3160 FOLSOM BLVD, SACRAMENTO, CA 95816-5219
(916) 733-3440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A8667
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000810568272
PHCS
CA
05
—
00AX86670
—
CA
01
—
102632
HEALTH NET
CA
01
—
1708821
GREAT WEST
CA
01
—
20A8667
BLUE CROSS
CA
01
—
2149412
FIRST HEALTH
CA
01
—
2358909
UNITED HEALTHCARE
CA
01
—
5013958
CIGNA
CA
01
—
7810479
AETNA
CA
01
—
90136584
PACIFICARE
CA
01
—
99081
INTERPLAN
CA
01
—
MCMG274500
WESTERN HEALTH ADVANTAGE
CA
Enumeration date
08/05/2006
Last updated
09/24/2007
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