Healthcare Provider Details

I. General information

NPI: 1790016772
Provider Name (Legal Business Name): NEHA PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2010
Last Update Date: 12/22/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 S FAIR OAKS AVE
PASADENA CA
91105-2625
US

IV. Provider business mailing address

312 W FIFTH ST APT 926
LOS ANGELES CA
90013-1900
US

V. Phone/Fax

Practice location:
  • Phone: 626-389-9300
  • Fax: 626-389-9336
Mailing address:
  • Phone: 832-257-4492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberBP10034255
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: