Provider Demographics
NPI:1437417904
Name:GANDHI RAHMAN, SACHIN N (MD)
Entity Type:Individual
Prefix:DR
First Name:SACHIN
Middle Name:N
Last Name:GANDHI RAHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SACHIN
Other - Middle Name:N
Other - Last Name:GANDHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1292 WAIANUENUE AVENUE
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720
Mailing Address - Country:US
Mailing Address - Phone:808-934-4000
Mailing Address - Fax:808-934-4061
Practice Address - Street 1:1292 WAIANUENUE AVENUE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-934-4000
Practice Address - Fax:808-934-4061
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122969207Q00000X, 390200000X
HIMD-18172207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA176419Medicare PIN