Healthcare Provider Details

I. General information

NPI: 1750085585
Provider Name (Legal Business Name): OJEL PATHAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10945 LE CONTE AVE STE 2339
LOS ANGELES CA
90095-1687
US

IV. Provider business mailing address

10945 LE CONTE AVE STE 2339
LOS ANGELES CA
90095-1687
US

V. Phone/Fax

Practice location:
  • Phone: 310-744-5836
  • Fax:
Mailing address:
  • Phone: 310-744-5836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number23745
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: