MEDICARE: ANANDRAY B PATEL D.O.

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	20A8911	CA
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	2OA8911	CA
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	20A8911	CA
4	207RP1001X	Pulmonary Disease Physician	2OA8911	CA

General Provider Information

NPI Number	:	1699710913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANANDRAY B PATEL D.O.

Provider Business Mailing Address
First Line	:	4130 PRINCETON PL
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-7955
Country	:	US
Telephone Number	:	323-810-5132
Fax Number	:

Provider Business Practice Location Address
First Line	:	3460 E LA PALMA AVE
Second Line	:	MEDICAL OFFICE BUILDING 1, 3RD FLOOR
City	:	ANAHEIM
State	:	CA
Zip	:	92806-2020
Country	:	US
Telephone Number	:	714-644-2169
Fax Number	:

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

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	12/06/2021

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