Healthcare Provider Details

I. General information

NPI: 1932308285
Provider Name (Legal Business Name): SEJAL M PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 11/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17900 VON KARMAN AVE STE 150
IRVINE CA
92614-4296
US

IV. Provider business mailing address

541 S SPRING STE 1201
LOS ANGELES CA
90013-1667
US

V. Phone/Fax

Practice location:
  • Phone: 424-652-8801
  • Fax:
Mailing address:
  • Phone: 424-652-8801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number238984
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA104427
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: