Healthcare Provider Details

I. General information

NPI: 1922430610
Provider Name (Legal Business Name): NEELAM PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2013
Last Update Date: 04/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 W SUNSET BLVD
LOS ANGELES CA
90027-6062
US

IV. Provider business mailing address

3701 WILSHIRE BLVD SUITE #600
LOS ANGELES CA
90010-2804
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-4100
  • Fax: 323-361-3642
Mailing address:
  • Phone: 323-361-3550
  • Fax: 323-361-8052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberA141217
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA09357600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: