Provider Demographics
NPI:1225648900
Name:GANDHI, MANISH
Entity Type:Individual
Prefix:
First Name:MANISH
Middle Name:
Last Name:GANDHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25283 CABOT RD STE 212
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5510
Mailing Address - Country:US
Mailing Address - Phone:714-470-8882
Mailing Address - Fax:
Practice Address - Street 1:25283 CABOT RD STE 212
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5510
Practice Address - Country:US
Practice Address - Phone:714-470-8882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care