Provider Demographics
NPI:1194086595
Name:PATEL, PARTH (PT)
Entity type:Individual
Prefix:
First Name:PARTH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 SAN MIGUEL DR STE 301
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7820
Mailing Address - Country:US
Mailing Address - Phone:949-759-0300
Mailing Address - Fax:949-759-9164
Practice Address - Street 1:360 SAN MIGUEL DR STE 301
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7820
Practice Address - Country:US
Practice Address - Phone:949-759-0300
Practice Address - Fax:949-759-9164
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38468225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist