Healthcare Provider Details

I. General information

NPI: 1598716011
Provider Name (Legal Business Name): ARUNA R PATIL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 W 190TH ST SUITE 205
GARDENA CA
90248-4320
US

IV. Provider business mailing address

PO BOX 5333
TORRANCE CA
90510-5333
US

V. Phone/Fax

Practice location:
  • Phone: 310-329-2469
  • Fax: 310-329-0176
Mailing address:
  • Phone: 310-329-2469
  • Fax: 310-329-0176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberC42739
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: