NPIMap

Organization Active NPI

Colorectal Center of San Diego, Inc.

  • Colon & Rectal Surgery Physician
  • Vista, CA
National Provider Identifier
1265779334
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
A103200 Issued in CA
Legal business name
COLORECTAL CENTER OF SAN DIEGO, INC.
Practice address
2095 W Vista Way
Suite 106
Vista, CA 92083-6027
Phone
(760) 691-9733
Fax
(760) 477-6056
NPI assigned
Jan 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Dhruvil Pradip Gandhi, M.D.
Title
President
Phone
(760) 691-9733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208C00000X A103200 CA Primary

Addresses

Primary practice location

2095 W Vista Way
Suite 106
Vista, CA 92083-6027

Mailing address

2095 W Vista Way
Suite 106
Vista, CA 92083-6027

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359417600000",
    "number": "1265779334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2095 W VISTA WAY",
            "address_2": "SUITE 106",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836027",
            "fax_number": "760-477-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 W VISTA WAY",
            "address_2": "SUITE 106",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836027",
            "telephone_number": "760-691-9733",
            "fax_number": "760-477-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORECTAL CENTER OF SAN DIEGO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-09",
        "last_updated": "2013-01-29",
        "status": "A",
        "authorized_official_last_name": "GANDHI",
        "authorized_official_first_name": "DHRUVIL",
        "authorized_official_middle_name": "PRADIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-691-9733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "A103200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.