# GERIATRIC SUPPORT MEDICAL GROUP PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548188931
- **Authorized official:** RAVI PATEL DO (PRESIDENT)
- **Authorized official phone:** (714) 698-4908

## Contact information

- **Practice address:** 880 APOLLO ST STE 217, EL SEGUNDO, CA 90245-4752
- **Practice address phone:** (714) 698-4908
- **Practice address fax:** (714) 698-4908
- **Mailing address:** 880 APOLLO ST STE 217, EL SEGUNDO, CA 90245-4752
- **Mailing address phone:** (714) 698-4908
- **Mailing address fax:** (714) 698-4908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/06/2026
- **Last updated:** 07/07/2026