Provider Demographics
NPI:1407052293
Name:L.A. UROLOGIY, INC.
Entity Type:Organization
Organization Name:L.A. UROLOGIY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BHARAT
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-483-2772
Mailing Address - Street 1:8306 WILSHIRE BLVD
Mailing Address - Street 2:SUITE #6700
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2304
Mailing Address - Country:US
Mailing Address - Phone:213-483-2772
Mailing Address - Fax:213-484-6317
Practice Address - Street 1:14624 SHERMAN WAY
Practice Address - Street 2:SUITE # 103
Practice Address - City:VAN NUYS,
Practice Address - State:CA
Practice Address - Zip Code:91405
Practice Address - Country:US
Practice Address - Phone:818-781-6620
Practice Address - Fax:213-484-6317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34922208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty