Provider Demographics
NPI:1639741788
Name:VIPAL GANDHI O.D. INC
Entity Type:Organization
Organization Name:VIPAL GANDHI O.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIPAL
Authorized Official - Middle Name:DINESH
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:310-395-5778
Mailing Address - Street 1:1234 7TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-1614
Mailing Address - Country:US
Mailing Address - Phone:310-395-5778
Mailing Address - Fax:310-458-9754
Practice Address - Street 1:1234 7TH ST STE 2
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1614
Practice Address - Country:US
Practice Address - Phone:310-395-5778
Practice Address - Fax:310-458-9754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty