Provider Demographics
NPI:1073707881
Name:PATEL, ANITA C (MD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:C
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 69A113
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90069-0028
Mailing Address - Country:US
Mailing Address - Phone:310-205-0212
Mailing Address - Fax:310-388-3138
Practice Address - Street 1:9730 WILSHIRE BLVD STE 104
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2003
Practice Address - Country:US
Practice Address - Phone:310-205-0212
Practice Address - Fax:310-388-3138
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2018-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA92098208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAQ151YMedicare PIN