Healthcare Provider Details

I. General information

NPI: 1699710913
Provider Name (Legal Business Name): ANANDRAY B PATEL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 12/06/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3460 E LA PALMA AVE MEDICAL OFFICE BUILDING 1, 3RD FLOOR
ANAHEIM CA
92806-2020
US

IV. Provider business mailing address

4130 PRINCETON PL
YORBA LINDA CA
92886-7955
US

V. Phone/Fax

Practice location:
  • Phone: 714-644-2169
  • Fax:
Mailing address:
  • Phone: 323-810-5132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A8911
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number2OA8911
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number20A8911
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2OA8911
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: