Provider Demographics
NPI:1548238660
Name:PATEL, DILIP CHHAGANBHAI (MD)
Entity Type:Individual
Prefix:
First Name:DILIP
Middle Name:CHHAGANBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 W BALL RD SUITE #212
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3737
Mailing Address - Country:US
Mailing Address - Phone:714-527-1000
Mailing Address - Fax:714-527-6626
Practice Address - Street 1:3400 W BALL RD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3737
Practice Address - Country:US
Practice Address - Phone:714-527-1000
Practice Address - Fax:714-527-6626
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45937207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A459370Medicaid
CAF19967Medicare UPIN
CA00A459370Medicaid