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General NPI Number Information
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NPI Number | 1275967648
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Entity Type | Organization
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Legal Business Name | NILESH PATEL D O INC
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Dates
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Enumeration Date | 08/21/2013
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 514 N PROSPECT AVE STE 100
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City | REDONDO BEACH
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State | CA
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Zip | 90277-3036
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Country | US
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Telephone | 310-376-2707
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Fax |
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Provider Business Mailing Address
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Address Line | 28031 VIA DE COSTA
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-5377
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Country | US
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Telephone | 714-347-1010
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NILESH PATEL
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Credential | DO
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Telephone | 707-319-0518
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 20A9454
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License Number State | CA
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