Provider Demographics
NPI:1396904975
Name:PATHAK, NIMESH J (MD)
Entity type:Individual
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First Name:NIMESH
Middle Name:J
Last Name:PATHAK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5175 E PACIFIC COAST HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3317
Mailing Address - Country:US
Mailing Address - Phone:562-431-2748
Mailing Address - Fax:562-372-2582
Practice Address - Street 1:5175 E PACIFIC COAST HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3317
Practice Address - Country:US
Practice Address - Phone:562-431-2748
Practice Address - Fax:562-372-2582
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2016-08-10
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Provider Licenses
StateLicense IDTaxonomies
CAA113231207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology