Provider Demographics
NPI:1417165309
Name:RAJAN PATEL CORPORATION
Entity Type:Organization
Organization Name:RAJAN PATEL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAJAN
Authorized Official - Middle Name:MAHENDRA
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-954-9280
Mailing Address - Street 1:8712 WILSHIRE BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2719
Mailing Address - Country:US
Mailing Address - Phone:310-954-9280
Mailing Address - Fax:310-952-9281
Practice Address - Street 1:8712 WILSHIRE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2719
Practice Address - Country:US
Practice Address - Phone:310-954-9280
Practice Address - Fax:310-954-9281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6041900001Medicare NSC