Healthcare Provider Details

I. General information

NPI: 1194958256
Provider Name (Legal Business Name): REENA R PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2009
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 S MYRTLE AVE
MONROVIA CA
91016-3425
US

IV. Provider business mailing address

1730 HUNTINGTON DR STE 203
SOUTH PASADENA CA
91030-4860
US

V. Phone/Fax

Practice location:
  • Phone: 626-765-7852
  • Fax: 626-606-3952
Mailing address:
  • Phone: 626-765-7852
  • Fax: 626-606-3952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA 109224
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: