Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A79162 | CA |
Y | 208600000X | Surgeon | A79162 | CA |
NPI | 1023032133 |
---|---|
Provider Name | Dr. Kaushal Ramesh Patel |
First Address | Los Angeles, CA 90027-6063 |
Second Address | Los Angeles, CA 90033-5320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A791620 | MEDICAL PPIN # (01) | CA |
I35926 | (02) | CA |