Provider Demographics
NPI:1700829512
Name:GANDHI, TRIPTY MANOJ (MD)
Entity Type:Individual
Prefix:DR
First Name:TRIPTY
Middle Name:MANOJ
Last Name:GANDHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1080 SCOTT BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-5237
Mailing Address - Country:US
Mailing Address - Phone:408-247-8100
Mailing Address - Fax:408-247-8112
Practice Address - Street 1:1080 SCOTT BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-5237
Practice Address - Country:US
Practice Address - Phone:408-247-8100
Practice Address - Fax:408-247-8112
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2009-12-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA60781207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA60781OtherLICENSE
CAG64378Medicare UPIN