Healthcare Provider Details

I. General information

NPI: 1003755067
Provider Name (Legal Business Name): INTENSIVE PRIMARY CARE MEDICAL GROUP, P.A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 THE GRN STE B
DOVER DE
19901-3618
US

IV. Provider business mailing address

8 THE GRN STE B
DOVER DE
19901-3618
US

V. Phone/Fax

Practice location:
  • Phone: 949-220-1820
  • Fax: 949-220-1920
Mailing address:
  • Phone: 949-220-1820
  • Fax: 949-220-1920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. SANJAY PATIL
Title or Position: OWNER
Credential: MD
Phone: 949-220-1820