Provider Demographics
NPI:1881631539
Name:PATEL, NIRAV S (MD)
Entity Type:Individual
Prefix:DR
First Name:NIRAV
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3791 KATELLA AVE
Mailing Address - Street 2:SUITE106
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3105
Mailing Address - Country:US
Mailing Address - Phone:562-430-3114
Mailing Address - Fax:562-430-7718
Practice Address - Street 1:3791 KATELLA AVE
Practice Address - Street 2:SUITE106
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3105
Practice Address - Country:US
Practice Address - Phone:562-430-3114
Practice Address - Fax:562-430-7718
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2011-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG794482084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG58715Medicare UPIN
CAWG79448CMedicare PIN