Faziela Gandara, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95025061 Issued in CA

Practice address

PO Box 12711
Newport Beach, CA 92658-5072

Phone

(949) 542-0546

NPI assigned

Jul 11, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Fazila Khan Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1508603069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12711",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926585072",
            "telephone_number": "949-542-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 12711",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926585072",
            "telephone_number": "949-542-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDARA",
        "first_name": "FAZIELA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FAZILA",
            "last_name": "KHAN",
            "credential": "FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Fred J Galluccio, M.D.
• Zaely Brianda Galvan
• Yuliana Gamez
• Gamma Management Partners LLC
• Gamma Neuro Diagnostics Inc
• Meliza Maria Gandara, LCSW
• Michelle Gandawidjaja
• Radhakrishan S Gandhi, M.D.
• Beckett Charles Gandolfi, PT, DPT
• Raeika Ganji

• Family Nurse Practitioner in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.