Provider Demographics
NPI:1972959898
Name:DOCS FOR(4) KIDS MEDICAL OFFICE
Entity Type:Organization
Organization Name:DOCS FOR(4) KIDS MEDICAL OFFICE
Other - Org Name:HITESH D PATEL/SANGEETA H PATEL,MDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANGEETA
Authorized Official - Middle Name:H
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-544-3430
Mailing Address - Street 1:13372 NEWPORT AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3426
Mailing Address - Country:US
Mailing Address - Phone:714-544-3430
Mailing Address - Fax:714-573-8330
Practice Address - Street 1:13372 NEWPORT AVE
Practice Address - Street 2:SUITE B
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3426
Practice Address - Country:US
Practice Address - Phone:714-544-3430
Practice Address - Fax:714-573-8330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA498672080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A49867Medicaid