Provider Demographics
NPI:1760504898
Name:SHARAD S. PATEL M.D. INC.
Entity Type:Organization
Organization Name:SHARAD S. PATEL M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARAD
Authorized Official - Middle Name:S
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-842-7778
Mailing Address - Street 1:201 S BUENA VISTA ST STE 440
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4577
Mailing Address - Country:US
Mailing Address - Phone:818-842-7778
Mailing Address - Fax:818-842-2086
Practice Address - Street 1:201 S BUENA VISTA ST STE 440
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4577
Practice Address - Country:US
Practice Address - Phone:818-842-7778
Practice Address - Fax:818-842-2086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25839174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24596Medicare UPIN