Healthcare Provider Details

I. General information

NPI: 1730508979
Provider Name (Legal Business Name): ABHIRAM GANDE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 E OHIO AVE
ESCONDIDO CA
92025-3418
US

IV. Provider business mailing address

1123 ARIANA RD
SAN MARCOS CA
92069-8122
US

V. Phone/Fax

Practice location:
  • Phone: 619-937-2640
  • Fax:
Mailing address:
  • Phone: 619-937-2640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberA138072
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: