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General NPI Number Information
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NPI Number | 1114377066
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Entity Type | Organization
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Legal Business Name | CENTRO MEDICO SU SALUD A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/21/2016
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Last Update Date | 03/23/2017
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Provider Practice Location Address
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Address Line | 9449 FIRESTONE BLVD
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City | DOWNEY
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State | CA
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Zip | 90241-5503
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Country | US
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Telephone | 562-622-0519
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Fax | 562-622-0522
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Provider Business Mailing Address
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Address Line | 9449 FIRESTONE BLVD
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City | DOWNEY
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State | CA
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Zip | 90241-5503
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Country | US
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Telephone | 213-622-0519
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Fax | 562-622-0522
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Authorized Official
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Title or Position | OWNER
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Name | DR. BHARAT PATEL
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Credential | M.D.
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Telephone | 213-622-0519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2088F0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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