Provider Demographics
NPI:1639619497
Name:PATEL, MEERA J (RN, NP)
Entity Type:Individual
Prefix:
First Name:MEERA
Middle Name:J
Last Name:PATEL
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4704 HERMANO DR
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4516
Mailing Address - Country:US
Mailing Address - Phone:310-948-0645
Mailing Address - Fax:
Practice Address - Street 1:4704 HERMANO DR
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4516
Practice Address - Country:US
Practice Address - Phone:310-948-0645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21863363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health