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NPI Code Detail

MEDICARE: AMOL PATEL MD

MEDICARE: AMOL PATEL MD
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
1207Q00000XFamily Medicine Physician23986NV

General Provider Information

NPI Number : 1821627316
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMOL PATEL MD
Provider Business Mailing Address
First Line : 13432 WASHINGTON BLVD
Second Line :
City : VENICE
State : CA
Zip : 90292-5626
Country : US
Telephone Number : 310-819-0536
Fax Number :
Provider Business Practice Location Address
First Line : 1799 MOUNT MARIAH DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-1501
Country : US
Telephone Number : 702-383-1961
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2020
Last Update Date : 08/16/2023

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Directions to “ AMOL PATEL MD” Practice Location

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