Provider Demographics
NPI:1376971986
Name:PURVI RASHMIKANT PATEL MD A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:PURVI RASHMIKANT PATEL MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEP
Authorized Official - Prefix:
Authorized Official - First Name:PURVI
Authorized Official - Middle Name:R
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-339-2243
Mailing Address - Street 1:928 N SAN FERNANDO BLVD
Mailing Address - Street 2:STE J237
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-4350
Mailing Address - Country:US
Mailing Address - Phone:818-339-2243
Mailing Address - Fax:818-569-3060
Practice Address - Street 1:928 N SAN FERNANDO BLVD
Practice Address - Street 2:STE J237
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-4350
Practice Address - Country:US
Practice Address - Phone:818-339-2243
Practice Address - Fax:818-569-3060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82356208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty