Healthcare Provider Details

I. General information

NPI: 1861803157
Provider Name (Legal Business Name): HARSHAD P PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HARSHADKUMAR PRAHALADBHAI PATEL

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 ATLANTIC AVE
LONG BEACH CA
90807
US

IV. Provider business mailing address

3650 ATLANTIC AVE
LONG BEACH CA
90807-3418
US

V. Phone/Fax

Practice location:
  • Phone: 562-988-2020
  • Fax: 562-426-7394
Mailing address:
  • Phone: 562-988-2020
  • Fax: 562-426-7394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License NumberA156730
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA156730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: