Provider Demographics
NPI:1316360316
Name:DIPTI PATEL PLLC
Entity Type:Organization
Organization Name:DIPTI PATEL PLLC
Other - Org Name:MOUNTAIN VIEW MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIPTI
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-388-3188
Mailing Address - Street 1:18715 N REEMS RD STE 140
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-8643
Mailing Address - Country:US
Mailing Address - Phone:623-388-3188
Mailing Address - Fax:623-322-7891
Practice Address - Street 1:14420 W. MEEKER BLVD BLDG A
Practice Address - Street 2:SUITE 200
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375
Practice Address - Country:US
Practice Address - Phone:623-388-3188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15419261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ166089OtherPTAN
AZZ 121595Medicare PIN
AZD44348Medicare UPIN