Provider Demographics
NPI:1215364294
Name:GANDHI, TAPAS SHAILESH (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAPAS
Middle Name:SHAILESH
Last Name:GANDHI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18406 SEINE AVE
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-5745
Mailing Address - Country:US
Mailing Address - Phone:562-881-7768
Mailing Address - Fax:
Practice Address - Street 1:18406 SEINE AVE
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-5745
Practice Address - Country:US
Practice Address - Phone:562-881-7768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69908183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist