Provider Demographics
NPI:1043446982
Name:PATEL, REEKESH R (MD)
Entity Type:Individual
Prefix:
First Name:REEKESH
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 252273
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-8979
Mailing Address - Country:US
Mailing Address - Phone:213-465-0994
Mailing Address - Fax:213-866-2772
Practice Address - Street 1:4477 W 118TH ST STE 501
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-2260
Practice Address - Country:US
Practice Address - Phone:213-465-0994
Practice Address - Fax:213-866-2772
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1260352081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB253101Medicare PIN