Healthcare Provider Details

I. General information

NPI: 1386682177
Provider Name (Legal Business Name): DR. SANGEETA HITESH PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: SANGEETA HITESH PATEL MD

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13372 NEWPORT AVE SUITE B
TUSTIN CA
92780-3426
US

IV. Provider business mailing address

13372 NEWPORT AVE SUITE B
TUSTIN CA
92780-3426
US

V. Phone/Fax

Practice location:
  • Phone: 714-544-3430
  • Fax: 714-573-8330
Mailing address:
  • Phone: 714-544-3430
  • Fax: 714-573-8330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA49867
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: