Healthcare Provider Details

I. General information

NPI: 1992957237
Provider Name (Legal Business Name): ANISH ANIL PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2008
Last Update Date: 10/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6155 CORNERSTONE CT E SUITE 220
SAN DIEGO CA
92121-4736
US

IV. Provider business mailing address

6155 CORNERSTONE CT E SUITE 220
SAN DIEGO CA
92121-4736
US

V. Phone/Fax

Practice location:
  • Phone: 858-458-2993
  • Fax: 858-458-4270
Mailing address:
  • Phone: 858-458-2993
  • Fax: 858-458-4270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA117372
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA117372
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.095851
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberA117372
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.095851
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number35.095851
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: