Provider Demographics
NPI:1023764271
Name:PREET PATEL, M.D. A PROFESSIONAL MEDICAL CORPORATION
Entity type:Organization
Organization Name:PREET PATEL, M.D. A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PREET
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-391-8568
Mailing Address - Street 1:1211 SUNSET PLAZA DR APT 410
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90069-1259
Mailing Address - Country:US
Mailing Address - Phone:267-391-8568
Mailing Address - Fax:
Practice Address - Street 1:1211 SUNSET PLAZA DR APT 410
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90069-1259
Practice Address - Country:US
Practice Address - Phone:267-391-8568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty