Provider Demographics
NPI:1992957237
Name:PATEL, ANISH ANIL (MD)
Entity type:Individual
Prefix:DR
First Name:ANISH
Middle Name:ANIL
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6155 CORNERSTONE CT E
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-4736
Mailing Address - Country:US
Mailing Address - Phone:858-458-2993
Mailing Address - Fax:858-458-4270
Practice Address - Street 1:6155 CORNERSTONE CT E
Practice Address - Street 2:SUITE 220
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-4736
Practice Address - Country:US
Practice Address - Phone:858-458-2993
Practice Address - Fax:858-458-4270
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2017-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA117372208M00000X, 207R00000X, 207RH0002X
OH35.095851207R00000X, 208M00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3084595Medicaid
OH3084595Medicaid
OH4302421Medicare PIN