Provider Demographics
NPI:1609138874
Name:GANDHE, RENU M (MD)
Entity Type:Individual
Prefix:
First Name:RENU
Middle Name:M
Last Name:GANDHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RENU
Other - Middle Name:RAMESH
Other - Last Name:DESHMUKH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3448 MOWRY AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1422
Mailing Address - Country:US
Mailing Address - Phone:510-373-3000
Mailing Address - Fax:510-744-9959
Practice Address - Street 1:520 LAWRENCE EXPRESSWAY
Practice Address - Street 2:STE 303
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085
Practice Address - Country:US
Practice Address - Phone:408-800-1771
Practice Address - Fax:408-890-5005
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA130447207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGPZZZ03209ZMedicare PIN