Provider Demographics
NPI:1821409129
Name:GHANDHARI, VANOUSHEH S (DPM)
Entity Type:Individual
Prefix:DR
First Name:VANOUSHEH
Middle Name:S
Last Name:GHANDHARI
Suffix:
Gender:F
Credentials:DPM
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Mailing Address - Street 1:270 W CHANDLER HEIGHTS RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-5084
Mailing Address - Country:US
Mailing Address - Phone:480-895-0276
Mailing Address - Fax:480-895-6933
Practice Address - Street 1:270 W CHANDLER HEIGHTS RD
Practice Address - Street 2:SUITE 5
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-5084
Practice Address - Country:US
Practice Address - Phone:480-895-0276
Practice Address - Fax:480-895-6933
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ864213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery