Provider Demographics
NPI:1508927914
Name:RANAVAT, AMRITLAL CHOONILAL (MD)
Entity Type:Individual
Prefix:MR
First Name:AMRITLAL
Middle Name:CHOONILAL
Last Name:RANAVAT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:201 S. ALVARADO ST.
Mailing Address - Street 2:# 824
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057
Mailing Address - Country:US
Mailing Address - Phone:213-413-6196
Mailing Address - Fax:213-413-1501
Practice Address - Street 1:1245 WILSHIRE BLVD
Practice Address - Street 2:STE 501
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4805
Practice Address - Country:US
Practice Address - Phone:213-413-6196
Practice Address - Fax:213-413-1501
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA35341207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A353410Medicaid
CA00A353410Medicaid
CAA35341Medicare UPIN
A84762Medicare UPIN