Healthcare Provider Details

I. General information

NPI: 1922053404
Provider Name (Legal Business Name): MAHENDRA N. PATEL, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10515 BALBOA BLVD SUITE 380
GRANADA HILLS CA
91344-6343
US

IV. Provider business mailing address

10515 BALBOA BLVD SUITE 380
GRANADA HILLS CA
91344-6343
US

V. Phone/Fax

Practice location:
  • Phone: 818-363-7120
  • Fax: 818-832-4420
Mailing address:
  • Phone: 818-363-7120
  • Fax: 818-832-4420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANN M. PATEL
Title or Position: ACCOUNTANT
Credential:
Phone: 818-363-7120