MEDICARE: DR. NIRAV HIRU PATEL D.P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT27537	CA

General Provider Information

NPI Number	:	1053480467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIRAV HIRU PATEL D.P.T.

Provider Business Mailing Address
First Line	:	24422 AVENIDA DE LA CARLOTA
Second Line	:	SUITE 190
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-7602
Country	:	US
Telephone Number	:	949-340-6927
Fax Number	:	949-215-7246

Provider Business Practice Location Address
First Line	:	24422 AVENIDA DE LA CARLOTA
Second Line	:	SUITE 190
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-7602
Country	:	US
Telephone Number	:	949-340-6927
Fax Number	:	949-215-7246

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	01/28/2011

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