MEDICARE: DR. AMI N PATEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	A88993	CA
2	207RH0003X	Hematology & Oncology Physician	A88993	CA
3	207RX0202X	Medical Oncology Physician	A88993	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A88993	OTHER	CA	AMI PATEL-LICENSE NO

General Provider Information

NPI Number	:	1518064278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMI N PATEL M.D.

Provider Business Mailing Address
First Line	:	1505 WILSON TER
Second Line	:	STE 340
City	:	GLENDALE
State	:	CA
Zip	:	91206-4072
Country	:	US
Telephone Number	:	818-543-7574
Fax Number	:	818-956-7609

Provider Business Practice Location Address
First Line	:	1505 WILSON TER
Second Line	:	SUITE 340
City	:	GLENDALE
State	:	CA
Zip	:	91206-4071
Country	:	US
Telephone Number	:	818-543-7574
Fax Number	:	818-956-7609

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	12/20/2023

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Directions to “ DR. AMI N PATEL M.D.” Practice Location

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