Healthcare Provider Details

I. General information

NPI: 1518172535
Provider Name (Legal Business Name): DARSHAN ASHOK PATEL M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2007
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15972 TUSCOLA RD STE 101
APPLE VALLEY CA
92307-2106
US

IV. Provider business mailing address

18031 US HIGHWAY 18 STE C
APPLE VALLEY CA
92307-2152
US

V. Phone/Fax

Practice location:
  • Phone: 760-810-7631
  • Fax: 760-810-7635
Mailing address:
  • Phone: 760-486-0116
  • Fax: 760-810-7635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA110591
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA110591
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberA110591
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: