Healthcare Provider Details

I. General information

NPI: 1558818179
Provider Name (Legal Business Name): TRISHA C. PATEL MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5475 E LA PALMA AVE STE 202
ANAHEIM CA
92807-2075
US

IV. Provider business mailing address

5475 E LA PALMA AVE STE 202
ANAHEIM CA
92807-2075
US

V. Phone/Fax

Practice location:
  • Phone: 949-396-0501
  • Fax: 714-829-3404
Mailing address:
  • Phone: 949-396-0501
  • Fax: 714-829-3404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA125677
License Number StateCA

VIII. Authorized Official

Name: TRISHA C PATEL
Title or Position: OWNER
Credential: MD
Phone: 850-316-7376