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General NPI Number Information
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NPI Number | 1568880292
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Entity Type | Individual
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Provider Name | MITESH KANTILAL PATEL MD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2014
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 201 S HARBOR BLVD
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City | LA HABRA
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State | CA
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Zip | 90631-5654
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Country | US
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Telephone | 760-631-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 VALE TERRACE DR
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City | VISTA
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State | CA
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Zip | 92084-5218
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Country | US
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Telephone | 760-631-5000
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Fax | 760-414-3892
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A181164
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 01080069A
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License Number State | IN
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