Healthcare Provider Details

I. General information

NPI: 1558820845
Provider Name (Legal Business Name): ANESH PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2019
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44045 MARGARITA RD STE 101
TEMECULA CA
92592-2729
US

IV. Provider business mailing address

31700 TEMECULA PKWY STE 2
TEMECULA CA
92592-5896
US

V. Phone/Fax

Practice location:
  • Phone: 951-302-1122
  • Fax:
Mailing address:
  • Phone: 951-600-4338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA180140
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: