Provider Demographics
NPI:1265664916
Name:GANDHI, KAMLESH (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KAMLESH
Middle Name:
Last Name:GANDHI
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5964 VIZZI CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-2858
Mailing Address - Country:US
Mailing Address - Phone:702-245-3717
Mailing Address - Fax:
Practice Address - Street 1:4055 S DURANGO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-4158
Practice Address - Country:US
Practice Address - Phone:702-245-3717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17254183500000X
IL051040311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist