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NPI Code Detail

MEDICARE: POONAM JITEN GANDHI

MEDICARE: POONAM JITEN GANDHI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist65670CA

General Provider Information

NPI Number : 1407133093
Entity Type Code : Individual
Provider Name (Legal Business Name) : POONAM JITEN GANDHI
Provider Business Mailing Address
First Line : 1330 E 17TH ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-8500
Country : US
Telephone Number : 714-403-1947
Fax Number :
Provider Business Practice Location Address
First Line : 1330 E 17TH ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-8500
Country : US
Telephone Number : 714-547-1042
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2011
Last Update Date : 11/09/2011

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Directions to “ POONAM JITEN GANDHI ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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