Provider Demographics
NPI:1730442948
Name:PATEL UROLOGY, PROFESSIONAL CORP
Entity type:Organization
Organization Name:PATEL UROLOGY, PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BHARAT
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-483-6322
Mailing Address - Street 1:8306 WILSHIRE BLVD # 6700
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2382
Mailing Address - Country:US
Mailing Address - Phone:213-483-6322
Mailing Address - Fax:
Practice Address - Street 1:2010 WILSHIRE BLVD STE 801
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3594
Practice Address - Country:US
Practice Address - Phone:213-483-6322
Practice Address - Fax:213-484-6317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43922208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty