Individual
DR. PANCH JEYAKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 880-7812
Mailing address
200 S MANCHESTER AVE STE 300, ORANGE, CA 92868-3219
(714) 456-2986
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A42736
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A42736
CA
207RP1001X
Pulmonary Disease Physician
Primary
A042736
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A427360
—
CA
01
—
P00000953
MEDICARE RR
CA
Enumeration date
03/17/2006
Last updated
02/07/2023
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