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General NPI Number Information
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NPI Number | 1912972795
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Entity Type | Individual
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Provider Name | PRATIBHA ASHOKKUMAR PATEL M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 12/18/2012
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Provider Practice Location Address
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Address Line | 2160 W 190TH ST
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City | TORRANCE
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State | CA
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Zip | 90504-6103
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Country | US
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Telephone | 310-783-5510
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Fax | 310-783-5597
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Provider Business Mailing Address
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Address Line | 4206 E LA PALMA AVE
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City | ANAHEIM
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State | CA
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Zip | 92807-1816
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Country | US
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Telephone | 562-988-7296
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Fax | 562-988-7400
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A 31386
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License Number State | CA
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