Healthcare Provider Details

I. General information

NPI: 1578978730
Provider Name (Legal Business Name): IPC HEARTCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 S RANCHO SANTA FE RD STE A15
ENCINITAS CA
92024-6309
US

IV. Provider business mailing address

162 S RANCHO SANTA FE RD STE A15
ENCINITAS CA
92024-6309
US

V. Phone/Fax

Practice location:
  • Phone: 858-500-1399
  • Fax:
Mailing address:
  • Phone: 858-500-1399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PRATIKSHA G GANDHI
Title or Position: CEO
Credential: M.D
Phone: 858-500-1399