Provider Demographics
NPI:1629635230
Name:SANGHANI, GOPI SAMIR (RPH)
Entity Type:Individual
Prefix:
First Name:GOPI
Middle Name:SAMIR
Last Name:SANGHANI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 S WHITE RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-4050
Mailing Address - Country:US
Mailing Address - Phone:408-238-9603
Mailing Address - Fax:
Practice Address - Street 1:3220 S WHITE RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-4050
Practice Address - Country:US
Practice Address - Phone:408-238-9603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49053183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist