Provider Demographics
NPI:1477856201
Name:DILIP G. PATEL MD INC
Entity Type:Organization
Organization Name:DILIP G. PATEL MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DILIP
Authorized Official - Middle Name:G
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-448-1234
Mailing Address - Street 1:3131 SANTA ANITA AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-1369
Mailing Address - Country:US
Mailing Address - Phone:626-448-1234
Mailing Address - Fax:626-448-6595
Practice Address - Street 1:3131 SANTA ANITA AVE STE 103
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-1369
Practice Address - Country:US
Practice Address - Phone:626-448-1234
Practice Address - Fax:626-448-6595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37584207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA37584Medicaid