Individual
DR. ALI PANDAMOUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1205 E NORTH ST, MANTECA, CA 95336-4932
(209) 823-3111
Mailing address
1205 E NORTH ST, MANTECA, CA 95336-4932
(209) 823-3111
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A136965
CA
207Q00000X
Family Medicine Physician
Primary
036.153861
IL
207Q00000X
Family Medicine Physician
A136965
CA
Other
Enumeration date
06/26/2013
Last updated
06/21/2023
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