Healthcare Provider Details

I. General information

NPI: 1427057843
Provider Name (Legal Business Name): SAUMIL M GANDHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 MARCH ST
SANTA PAULA CA
93060-2511
US

IV. Provider business mailing address

4030 TRADEWINDS DR
OXNARD CA
93035-1253
US

V. Phone/Fax

Practice location:
  • Phone: 805-525-4650
  • Fax: 805-648-6572
Mailing address:
  • Phone: 805-525-4650
  • Fax: 805-648-6572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA54272
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: