Healthcare Provider Details

I. General information

NPI: 1992118210
Provider Name (Legal Business Name): SONAL GANDHI BUHAIN RN, BSN, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 05/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24085 AMADOR ST
HAYWARD CA
94544-1222
US

IV. Provider business mailing address

24085 AMADOR ST
HAYWARD CA
94544-1222
US

V. Phone/Fax

Practice location:
  • Phone: 510-385-3149
  • Fax: 951-358-5019
Mailing address:
  • Phone: 510-385-3149
  • Fax: 951-358-5019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number847633
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: