Basic Information
Provider Information
NPI: 1689847980
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: YASH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1850 N CENTRAL AVE
Address2: STE 1600
City: PHOENIX
State: AZ
PostalCode: 850044633
CountryCode: US
TelephoneNumber: 6022628900
FaxNumber: 6022628890
Practice Location
Address1: 1850 N CENTRAL AVE STE 1600
Address2:  
City: PHOENIX
State: AZ
PostalCode: 85004
CountryCode: US
TelephoneNumber: 6022628900
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/08/2008
LastUpdateDate: 05/13/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA121589CAY Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000X53174AZN Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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