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General NPI Number Information
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NPI Number | 1336379700
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Entity Type | Organization
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Legal Business Name | PRITI DESAI, MD INC.
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 07/20/2009
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Provider Practice Location Address
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Address Line | 315 N 3RD AVE SUITE 205
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City | COVINA
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State | CA
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Zip | 91723-1905
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Country | US
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Telephone | 626-332-4543
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Fax | 626-332-2228
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Provider Business Mailing Address
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Address Line | 315 N 3RD AVE SUITE 205
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City | COVINA
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State | CA
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Zip | 91723-1905
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Country | US
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Telephone | 626-332-4543
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Fax | 626-332-2228
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Authorized Official
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Title or Position | OWNER
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Name | DR. PRITI DESAI
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Credential |
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Telephone | 626-332-4543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | A80894
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License Number State | CA
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