Provider Demographics
NPI:1083887277
Name:GANDHI, DHRUVIL PRADIP (MD)
Entity Type:Individual
Prefix:DR
First Name:DHRUVIL
Middle Name:PRADIP
Last Name:GANDHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2095 W VISTA WAY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-6027
Mailing Address - Country:US
Mailing Address - Phone:760-295-2924
Mailing Address - Fax:760-542-6382
Practice Address - Street 1:2095 W VISTA WAY
Practice Address - Street 2:SUITE 106
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6027
Practice Address - Country:US
Practice Address - Phone:760-295-2924
Practice Address - Fax:760-542-6382
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 1032000208C00000X
CAA103200208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery