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General NPI Number Information
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NPI Number | 1225269434
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Entity Type | Organization
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Legal Business Name | DIPESH K. GANDHI,MD,INC
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Dates
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Enumeration Date | 08/05/2009
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 1100 MARSHALL WAY
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City | PLACERVILLE
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State | CA
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Zip | 95667-6533
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Country | US
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Telephone | 916-276-2226
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Fax | 951-600-5969
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Provider Business Mailing Address
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Address Line | 26281 KOBE PL
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City | MURRIETA
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State | CA
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Zip | 92563-4958
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Country | US
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Telephone | 951-600-5969
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Fax | 951-600-5969
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DIPESH K GANDHI
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Credential | M.D.
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Telephone | 916-276-2226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A44920
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License Number State | CA
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