| Phantom Medical, Inc. | |
|
1240 E Chapman Ave Orange CA 92866-2217 | |
| (714) 771-2800 | |
| (714) 771-3200 |
| Full Name | Phantom Medical, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1240 E Chapman Ave, Orange, California |
| Authorized Official Name and Position | Neal H. Patel (OWNER) |
| Authorized Official Contact | 7144027731 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phantom Medical, Inc. 1240 E Chapman Ave Orange CA 92866-2217 Ph: (714) 771-2800 | Phantom Medical, Inc. 1240 E Chapman Ave Orange CA 92866-2217 Ph: (714) 771-2800 |
| NPI Number | 1790390052 |
|---|---|
| Provider Enumeration Date | 09/14/2020 |
| Last Update Date | 09/14/2020 |
| Medicare PECOS PAC ID | 0042621765 |
|---|---|
| Medicare Enrollment ID | O20201201000799 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790390052 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Neal H Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730543919 PECOS PAC ID: 9931443876 Enrollment ID: I20181204003237 |
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