Provider Demographics
NPI:1952633000
Name:ATU C PATEL M.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ATU C PATEL M.D., A PROFESSIONAL CORPORATION
Other - Org Name:PRIME DIAGNOSTIC IMAGING, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDIENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ATULKUMAR
Authorized Official - Middle Name:C
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-822-0202
Mailing Address - Street 1:PO BOX 824
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-0824
Mailing Address - Country:US
Mailing Address - Phone:562-822-0202
Mailing Address - Fax:
Practice Address - Street 1:1109 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2212
Practice Address - Country:US
Practice Address - Phone:562-822-0202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-30
Last Update Date:2010-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A38703261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology