Healthcare Provider Details

I. General information

NPI: 1902844889
Provider Name (Legal Business Name): HITESH D PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 09/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 SOUTH ANAHEIM BLVD
ANAHEIM CA
92805-3426
US

IV. Provider business mailing address

1311 S ANAHEIM BLVD
ANAHEIM CA
92805-6206
US

V. Phone/Fax

Practice location:
  • Phone: 714-635-6400
  • Fax: 714-635-6433
Mailing address:
  • Phone: 714-635-6400
  • Fax: 714-635-6433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA50292
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: