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15963 Quantico Rd Suite C, Apple Valley CA 92307-0839 | |
(760) 242-4810 | |
(760) 242-4760 |
Full Name | |
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Speciality | Psychiatry & Neurology |
Location | 15963 Quantico Rd, Apple Valley, California |
Authorized Official Name and Position | Ravi Ashok Patel (CEO AND PRESIDENT) |
Authorized Official Contact | 7602424810 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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15963 Quantico Rd Suite C, Apple Valley CA 92307-0839 Ph: (760) 242-4810 | 15963 Quantico Rd Suite C, Apple Valley CA 92307-0839 Ph: (760) 242-4810 |
NPI Number | 1194093229 |
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Provider Enumeration Date | 12/04/2011 |
Last Update Date | 08/30/2012 |
Medicare PECOS PAC ID | 1052572948 |
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Medicare Enrollment ID | O20120420000202 |
Identifier | Type | State | Issuer |
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1194093229 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084N0400X | Psychiatry & Neurology - Neurology | A115902 (California) | Primary |
Provider Name | Ravi A Patel |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1962667790 PECOS PAC ID: 5294850244 Enrollment ID: I20120423000021 |
Provider Name | Veena Patel |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1942528286 PECOS PAC ID: 0143483917 Enrollment ID: I20120515000716 |
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