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General NPI Number Information
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NPI Number | 1407874134
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Entity Type | Organization
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Legal Business Name | HIGH DESERT GASTROENTEROLOGY INC
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 06/05/2014
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Provider Practice Location Address
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Address Line | 1753 W AVENUE J STE B STE B
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City | LANCASTER
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State | CA
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Zip | 93534-9823
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Country | US
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Telephone | 661-948-0803
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Fax | 661-948-5004
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Provider Business Mailing Address
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Address Line | PO BOX 5988
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City | LANCASTER
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State | CA
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Zip | 93539-5988
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Country | US
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Telephone | 661-948-0803
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Fax | 661-948-5004
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. RAMAN M. PATEL
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Credential | M.D.
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Telephone | 661-948-0803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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