MEDICARE: MS. APEXA PATEL PA, AT

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	363A00000X	Physician Assistant	PA58940	CA
2	2255A2300X	Athletic Trainer	AT003010	GA
3	363A00000X	Physician Assistant	9449	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0	OTHER		NOT A MEDICARE OR MEDICADE PROVIDER

General Provider Information

NPI Number	:	1548713886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. APEXA PATEL PA, AT

Provider Business Mailing Address
First Line	:	4140 W 190TH ST
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90504-5513
Country	:	US
Telephone Number	:	310-423-4536
Fax Number	:

Provider Business Practice Location Address
First Line	:	1532 GRAND CONCOURSE STE A
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10457-8400
Country	:	US
Telephone Number	:	718-299-7295
Fax Number	:	718-299-6797

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

Provider Enumeration Date	:	08/03/2016
Last Update Date	:	11/26/2025

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