Healthcare Provider Details

I. General information

NPI: 1174694079
Provider Name (Legal Business Name): NEHAL G PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23141 VERDUGO DR STE 201
LAGUNA HILLS CA
92653-1341
US

IV. Provider business mailing address

23141 VERDUGO DR STE 201
LAGUNA HILLS CA
92653-1341
US

V. Phone/Fax

Practice location:
  • Phone: 949-215-5055
  • Fax:
Mailing address:
  • Phone: 949-215-5055
  • Fax: 949-326-5099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberA75898
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberA75898
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: