Provider Demographics
NPI:1578103693
Name:CITRUS FAMILY PRACTICE INC
Entity Type:Organization
Organization Name:CITRUS FAMILY PRACTICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEHAL
Authorized Official - Middle Name:GORDHAN
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-964-0063
Mailing Address - Street 1:20540 E ARROW HWY STE A
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-1200
Mailing Address - Country:US
Mailing Address - Phone:626-513-7497
Mailing Address - Fax:
Practice Address - Street 1:20540 E ARROW HWY STE A
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-1200
Practice Address - Country:US
Practice Address - Phone:626-513-7497
Practice Address - Fax:626-513-7497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-07
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty