Individual
SANDEEP GIDVANI
Active
Individual
SANDEEP GIDVANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
A120186
CA
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
A120186
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801002134
—
CA
01
—
6740500001
GROUP MEDICARE PTAN
CA
01
—
A120186
STATE LICENSE
CA
01
—
FY744A
MEDICARE GROUP PTAN
CA
Enumeration date
05/15/2007
Last updated
07/15/2020
Update your record
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