Healthcare Provider Details
I. General information
NPI: 1598775538
Provider Name (Legal Business Name): ILEANA M PAT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/09/2006
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
22110 ROSCOE BLVD STE 307
WEST HILLS CA
91304-3860
US
IV. Provider business mailing address
2475 GARDEN FALLS DR
CONROE TX
77384-2122
US
V. Phone/Fax
- Phone: 818-497-7857
- Fax: 818-394-6966
- Phone: 818-497-7857
- Fax: 818-350-0555
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | A69940 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: