Organization
GERIATRIC SUPPORT MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVI PATEL DO (PRESIDENT)
(714) 698-4908
Entity
Organization
Contact information
Practice address
880 APOLLO ST STE 217, EL SEGUNDO, CA 90245-4752
(714) 698-4908
(714) 698-4908
Mailing address
880 APOLLO ST STE 217, EL SEGUNDO, CA 90245-4752
(714) 698-4908
(714) 698-4908
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
07/06/2026
Last updated
07/07/2026
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