Provider Demographics
NPI:1093757403
Name:GANDHI, SUNIL (MD)
Entity Type:Individual
Prefix:
First Name:SUNIL
Middle Name:
Last Name:GANDHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 OAK GROVE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2536
Mailing Address - Country:US
Mailing Address - Phone:925-296-7150
Mailing Address - Fax:925-296-7171
Practice Address - Street 1:2125 OAK GROVE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2536
Practice Address - Country:US
Practice Address - Phone:925-296-7150
Practice Address - Fax:925-296-7171
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA777332085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A777332Medicare PIN
CA00A777336Medicare PIN
CA00A777331Medicare PIN
CA00A7773310Medicare PIN
CAI31861Medicare UPIN
CA00A7773313Medicare PIN
CA00A7773317Medicare PIN
CA00A7773319Medicare PIN
CAP00355003Medicare PIN
CAP00359367Medicare PIN
CA00A7773311Medicare PIN
CA00A7773321Medicare PIN
CA00A7773316Medicare PIN
CA00A7773318Medicare PIN
CA00A7773322Medicare PIN
CA00A777335Medicare PIN
CA00A777338Medicare PIN
CA00A7773314Medicare PIN
CA00A7773320Medicare PIN
CA00A777333Medicare PIN
CA00A777337Medicare PIN
CA00A777339Medicare PIN
CAP00325989Medicare PIN
CA00A7773312Medicare PIN
CA00A7773315Medicare PIN