MEDICARE: DR. NILESH PATEL D.O.

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	207L00000X	Anesthesiology Physician	20A9454	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518931112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NILESH PATEL D.O.

Provider Business Mailing Address
First Line	:	210 N TUSTIN AVE
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-3807
Country	:	US
Telephone Number	:	714-347-1010
Fax Number	:	714-647-1245

Provider Business Practice Location Address
First Line	:	1300 N VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-6005
Country	:	US
Telephone Number	:	213-413-3000
Fax Number	:

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	06/23/2014

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