Provider Demographics
NPI:1043499460
Name:GOWD, PAMPANA (MD)
Entity type:Individual
Prefix:
First Name:PAMPANA
Middle Name:
Last Name:GOWD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:B.M.PAMPANA
Other - Middle Name:
Other - Last Name:GOWD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2901 SILLECT AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-6372
Mailing Address - Country:US
Mailing Address - Phone:661-323-8384
Mailing Address - Fax:
Practice Address - Street 1:2901 SILLECT AVE STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-6372
Practice Address - Country:US
Practice Address - Phone:661-323-8384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA228906207R00000X
NJ25MA11388500207RC0000X
CAA115621207RC0000X
CT047941207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001479410Medicaid
CTD400019499 - C00814Medicare PIN