Individual
KETAN PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2720 N HARBOR BLVD STE 210, FULLERTON, CA 92835-2626
(714) 446-5192
(714) 446-5169
Mailing address
2720 N HARBOR BLVD STE 210, FULLERTON, CA 92835-2626
(714) 446-5192
(732) 515-8360
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
A184155
CA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
25MA10871500
NJ
208VP0000X
Pain Medicine Physician
Primary
A184155
CA
208VP0014X
Interventional Pain Medicine Physician
A184155
CA
Other
Enumeration date
07/01/2015
Last updated
10/02/2023
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