Provider Demographics
NPI:1730408790
Name:PAMILA K BRAR MD, INC.
Entity type:Organization
Organization Name:PAMILA K BRAR MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMILA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BRAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-922-2624
Mailing Address - Street 1:3525 DEL MAR HEIGHTS RD
Mailing Address - Street 2:#126
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2122
Mailing Address - Country:US
Mailing Address - Phone:858-922-2624
Mailing Address - Fax:
Practice Address - Street 1:9850 GENESEE AVE
Practice Address - Street 2:SUITE 570
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1224
Practice Address - Country:US
Practice Address - Phone:858-922-2624
Practice Address - Fax:858-346-9062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-28
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62754207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty