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General NPI Number Information
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NPI Number | 1891983581
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Entity Type | Individual
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Provider Name | SHITAL GANDHI MD
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Gender | Female
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 08/20/2018
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Provider Practice Location Address
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Address Line | 500 REDWOOD BLVD STE 300
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City | NOVATO
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State | CA
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Zip | 94947
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Country | US
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Telephone | 415-884-3415
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Fax | 415-883-0877
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Provider Business Mailing Address
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Address Line | PO BOX 6102 RADIOLOGY DEPARTMENT
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City | NOVATO
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State | CA
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Zip | 94948-6102
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Country | US
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Telephone | 415-884-3415
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Fax | 415-883-0877
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 248309
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | C56219
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License Number State | CA
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