Provider Demographics
NPI:1265402150
Name:GANDHI, DIPESHKUMAR K (MD)
Entity type:Individual
Prefix:
First Name:DIPESHKUMAR
Middle Name:K
Last Name:GANDHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DIPESH
Other - Middle Name:K
Other - Last Name:GANDHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:949 CALHOUN PL
Mailing Address - Street 2:SUITE D
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4403
Mailing Address - Country:US
Mailing Address - Phone:951-652-8000
Mailing Address - Fax:951-929-6431
Practice Address - Street 1:949 CALHOUN PL
Practice Address - Street 2:SUITE D
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4403
Practice Address - Country:US
Practice Address - Phone:951-652-8000
Practice Address - Fax:951-929-6431
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44920207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00068752OtherRAILROAD MEDICARE
CA00A4492000Medicaid
CA00A449202Medicare PIN