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General NPI Number Information
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NPI Number | 1942517552
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Entity Type | Organization
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Legal Business Name | SHIRISH B. PATEL M.D. INC
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Dates
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Enumeration Date | 09/02/2010
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 3650 SOUTH ST STE 106
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City | LAKEWOOD
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State | CA
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Zip | 90712-1532
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Country | US
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Telephone | 562-925-7401
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Fax | 310-554-4045
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Provider Business Mailing Address
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Address Line | 3650 E. SOUTH ST STE 106 SUITE 106
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City | LAKEWOOD
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State | CA
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Zip | 90712-1532
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Country | US
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Telephone | 562-925-7401
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Fax | 310-554-4045
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Authorized Official
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Title or Position | ASSOCIATE DIRECTOR OF PRACTICE MNGT
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Name | MARIA VILLA
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Credential |
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Telephone | 562-925-7401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A40789
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License Number State | CA
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