Healthcare Provider Details

I. General information

NPI: 1164786893
Provider Name (Legal Business Name): ASHISH B PATEL MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 CONGRESS ST SUITE 201
PASADENA CA
91105-3024
US

IV. Provider business mailing address

39 CONGRESS ST SUITE 201
PASADENA CA
91105-3024
US

V. Phone/Fax

Practice location:
  • Phone: 626-486-0181
  • Fax:
Mailing address:
  • Phone: 626-486-0181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA82228
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberA82228
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA82228
License Number StateCA

VIII. Authorized Official

Name: ASHISH B PATEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 626-486-0181