Basic Information
Provider Information
NPI: 1447296116
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: SWATI
MiddleName: N.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: FILE 4501
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900740001
CountryCode: US
TelephoneNumber: 5033722740
FaxNumber: 5033722754
Practice Location
Address1: 10833 LE CONTE AVE
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900953075
CountryCode: US
TelephoneNumber: 3108259111
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/21/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XG81540CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
00G81540001CABLUE SHIELD OF CAOTHER
00G81540030301CACALOPTIMAOTHER
00G81540005CA MEDICAID


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