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General NPI Number Information
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NPI Number | 1972824753
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Entity Type | Individual
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Provider Name | ANIL KRISHNAKUMAR GANDHI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2010
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Last Update Date | 02/21/2018
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Provider Practice Location Address
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Address Line | 12231 ARTESIA BLVD.
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City | CERRITOS
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State | CA
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Zip | 90703-8143
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Country | US
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Telephone | 562-653-0180
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Fax | 562-402-3029
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Provider Business Mailing Address
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Address Line | 12231 ARTESIA BLVD.
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City | CERRITOS
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State | CA
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Zip | 90703-8143
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Country | US
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Telephone | 562-653-0180
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Fax | 562-402-3029
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A30411
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A30411
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License Number State | CA
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