MEDICARE: ANAHEIM MARKET CLINIC

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	207Q00000X	Family Medicine Physician	A50292	CA

General Provider Information

NPI Number	:	1790916237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANAHEIM MARKET CLINIC

Provider Business Mailing Address
First Line	:	1311 S.ANAHEIM BLVD.
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92805
Country	:	US
Telephone Number	:	714-635-6400
Fax Number	:	714-635-6433

Provider Business Practice Location Address
First Line	:	1311 S.ANAHEIM BLVD
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92805
Country	:	US
Telephone Number	:	714-635-6400
Fax Number	:	714-635-6433

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. HITESH D PATEL
Credential	:	MD
Telephone Number	:	714-635-6600

Provider Enumeration Date	:	07/31/2009
Last Update Date	:	07/31/2009

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Directions to “ANAHEIM MARKET CLINIC ” Practice Location

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