Provider Demographics
NPI:1568651743
Name:PATEL, RESHMA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:RESHMA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:9415 CULVER BLVD # 56
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-2616
Mailing Address - Country:US
Mailing Address - Phone:424-259-2089
Mailing Address - Fax:209-759-2769
Practice Address - Street 1:9415 CULVER BLVD # 56
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2616
Practice Address - Country:US
Practice Address - Phone:424-259-2089
Practice Address - Fax:209-759-2769
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA17272363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant