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General NPI Number Information
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NPI Number | 1225139140
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Entity Type | Individual
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Provider Name | CHARU PATEL D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8116 CALIFORNIA AVE STE C
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City | SOUTH GATE
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State | CA
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Zip | 90280-2400
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Country | US
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Telephone | 323-567-1821
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Fax |
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Provider Business Mailing Address
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Address Line | 16137 AVENIDA SAN MIGUEL
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City | LA MIRADA
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State | CA
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Zip | 90638-3443
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 29979
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License Number State | CA
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