Individual provider Active NPI

Gagan Preet Sandhu, FNP

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1700048212
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13415 Issued in CA
Practice address
2121 S San Pedro St
Los Angeles, CA 90011-1160
Phone
(213) 742-0300
NPI assigned
Jun 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 13415 CA Primary

Addresses

Primary practice location

2121 S San Pedro St
Los Angeles, CA 90011-1160

Mailing address

10613 Newville Ave
Downey, CA 90241-3044
Phone (562) 889-6209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13415CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Khosro Vahid, M.D. a Medical Corporation PastSince Mar 12, 2013 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1700048212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10613 NEWVILLE AVE",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902413044",
            "telephone_number": "562-889-6209",
            "fax_number": "562-923-5341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 S SAN PEDRO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900111160",
            "telephone_number": "213-742-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHU",
        "first_name": "GAGAN",
        "middle_name": "PREET",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "13415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.