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General NPI Number Information
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NPI Number | 1982786752
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Entity Type | Individual
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Provider Name | PRITI PATEL HURD PA
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Gender | Female
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 10/01/2009
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Provider Practice Location Address
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Address Line | 1328 22ND ST EMERGENCY DEPARTMENT
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City | SANTA MONICA
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State | CA
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Zip | 90404-2032
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Country | US
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Telephone | 310-582-7089
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 55323
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City | SHERMAN OAKS
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State | CA
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Zip | 91413-0323
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Country | US
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Telephone | 402-715-4467
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2005031147
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1501035
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 19770
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License Number State | CA
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