Healthcare Provider Details

I. General information

NPI: 1538588306
Provider Name (Legal Business Name): GAURI GADRE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GAURI BHUCHAR

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 07/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10666 N TORREY PINES RD
LA JOLLA CA
92037
US

IV. Provider business mailing address

10790 RANCHO BERNARDO RD
SAN DIEGO CA
92127-5705
US

V. Phone/Fax

Practice location:
  • Phone: 858-554-7909
  • Fax: 858-554-3365
Mailing address:
  • Phone: 858-554-7909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A16465
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number20A16465
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: