Provider Demographics
NPI:1316267131
Name:GANDHI, SANDIP R (RPH)
Entity type:Individual
Prefix:MR
First Name:SANDIP
Middle Name:R
Last Name:GANDHI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 ATLANTIC AVE
Mailing Address - Street 2:RITE AID 5521
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807
Mailing Address - Country:US
Mailing Address - Phone:562-423-0036
Mailing Address - Fax:
Practice Address - Street 1:4402 ATLANTIC AVE
Practice Address - Street 2:RITE AID 5521
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2207
Practice Address - Country:US
Practice Address - Phone:562-423-0036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42092183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist