Healthcare Provider Details

I. General information

NPI: 1639619497
Provider Name (Legal Business Name): MEERA J PATEL RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2017
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CONTINENTAL BLVD STE 635
EL SEGUNDO CA
90245-5040
US

IV. Provider business mailing address

4704 HERMANO DR
TARZANA CA
91356-4516
US

V. Phone/Fax

Practice location:
  • Phone: 562-335-2730
  • Fax:
Mailing address:
  • Phone: 310-948-0645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number21863
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: