Provider Demographics
NPI:1508072497
Name:PATEL, RASOOL II (DDS)
Entity Type:Individual
Prefix:DR
First Name:RASOOL
Middle Name:
Last Name:PATEL
Suffix:II
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 255TH ST
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-2614
Mailing Address - Country:US
Mailing Address - Phone:310-367-7231
Mailing Address - Fax:
Practice Address - Street 1:12504 W WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5506
Practice Address - Country:US
Practice Address - Phone:310-390-6272
Practice Address - Fax:310-390-6674
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33374122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist