Provider Demographics
NPI:1396177564
Name:GANDHI, ANSHUL (MD)
Entity type:Individual
Prefix:DR
First Name:ANSHUL
Middle Name:
Last Name:GANDHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 S SPRING ST UNIT 13308
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-3215
Mailing Address - Country:US
Mailing Address - Phone:714-696-1264
Mailing Address - Fax:
Practice Address - Street 1:401 FAIRWAY DR STE 200
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1800
Practice Address - Country:US
Practice Address - Phone:714-696-1264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2023-10-04
Deactivation Date:2021-06-04
Deactivation Code:
Reactivation Date:2021-12-09
Provider Licenses
StateLicense IDTaxonomies
TXS4141207P00000X
CAA140220207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine