Basic Information
| Provider Information | |||||||||
| NPI: | 1811947898 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GANDHY | ||||||||
| FirstName: | MEERA | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11277 E 26TH ST | ||||||||
| Address2: | |||||||||
| City: | YUMA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853677298 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9283410335 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3220 E 40TH ST | ||||||||
| Address2: | THE EXCEL GROUP | ||||||||
| City: | YUMA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853657748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9283410335 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2006 | ||||||||
| LastUpdateDate: | 01/15/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 32091 | AZ | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 816035 | 01 | AZ | AHCCCS # | OTHER |