Provider Demographics
NPI:1467845198
Name:PATEL, NIDHI HARSHAD (DO)
Entity Type:Individual
Prefix:DR
First Name:NIDHI
Middle Name:HARSHAD
Last Name:PATEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:NIDHI
Other - Middle Name:SANDIP
Other - Last Name:SURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 15090
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92803-5090
Mailing Address - Country:US
Mailing Address - Phone:714-772-8282
Mailing Address - Fax:714-772-6493
Practice Address - Street 1:1211 W LA PALMA AVE STE 404
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2806
Practice Address - Country:US
Practice Address - Phone:714-772-8282
Practice Address - Fax:714-772-6493
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A16617207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine