Provider Demographics
NPI:1053480467
Name:PATEL, NIRAV HIRU (DPT)
Entity Type:Individual
Prefix:DR
First Name:NIRAV
Middle Name:HIRU
Last Name:PATEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24422 AVENIDA DE LA CARLOTA
Mailing Address - Street 2:SUITE 190
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-7602
Mailing Address - Country:US
Mailing Address - Phone:949-340-6927
Mailing Address - Fax:949-215-7246
Practice Address - Street 1:24422 AVENIDA DE LA CARLOTA
Practice Address - Street 2:SUITE 190
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7602
Practice Address - Country:US
Practice Address - Phone:949-340-6927
Practice Address - Fax:949-215-7246
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT27537225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WPT27537AMedicare PIN
CAQ63153Medicare UPIN
Q63153Medicare UPIN