Healthcare Provider Details

I. General information

NPI: 1396451928
Provider Name (Legal Business Name): TANHA HITESH PATEL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2023
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9850 GENESEE AVE STE 710
LA JOLLA CA
92037-1218
US

IV. Provider business mailing address

9850 GENESEE AVE STE 710
LA JOLLA CA
92037-1218
US

V. Phone/Fax

Practice location:
  • Phone: 858-260-2977
  • Fax: 858-260-2978
Mailing address:
  • Phone: 858-260-2977
  • Fax: 858-260-2978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA62478
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA62478
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: