MEDICARE: AKASH PATEL

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	2084P0800X	Psychiatry Physician	A189878	CA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1669113379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AKASH PATEL

Provider Business Mailing Address
First Line	:	1330 E COOLEY DR
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324-3905
Country	:	US
Telephone Number	:	909-580-3705
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 E COOLEY DR
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324-3905
Country	:	US
Telephone Number	:	909-580-3705
Fax Number	:

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

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	06/10/2026

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1003855172 — GLEN R. GAERTE O.D.
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Directions to “ AKASH PATEL ” Practice Location

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