Provider Demographics
NPI:1821369877
Name:GANDHI, KUMAR S (MD)
Entity type:Individual
Prefix:
First Name:KUMAR
Middle Name:S
Last Name:GANDHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1200 N STATE ST
Mailing Address - Street 2:CT-A7D
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1029
Mailing Address - Country:US
Mailing Address - Phone:323-226-7556
Mailing Address - Fax:323-226-3867
Practice Address - Street 1:1200 N STATE ST
Practice Address - Street 2:CT-A7D
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-226-7556
Practice Address - Fax:323-226-3867
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2018-08-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA122756207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA113786OtherSID # 113786