Organization Active NPI

Mayur C Patel MD, a Medical Corporation

  • Specialist
  • Burbank, CA
National Provider Identifier
1144400300
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A056296 Issued in CA
Legal business name
MAYUR C PATEL MD, A MEDICAL CORPORATION
Practice address
2625 W Alameda Ave
#506
Burbank, CA 91505-4806
Phone
(818) 843-5864
Fax
(818) 843-5860
NPI assigned
Nov 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mayur C Patel, M.D.NPI 1669451571
Title
Physician/Owner
Phone
(818) 843-5864

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A056296 CA Primary

Addresses

Primary practice location

2625 W Alameda Ave
#506
Burbank, CA 91505-4806

Mailing address

2625 W Alameda Ave
#506
Burbank, CA 91505-4806
Phone (818) 843-5864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050322001157 CA Part B Supplier - Clinic/Group Practice 8325094477 Receives reassigned benefits from 2 practitioners
Practice locations: Burbank, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311638400000",
    "number": "1144400300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 W ALAMEDA AVE",
            "address_2": "#506",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054806",
            "telephone_number": "818-843-5864",
            "fax_number": "818-846-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 W ALAMEDA AVE",
            "address_2": "#506",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054806",
            "telephone_number": "818-843-5864",
            "fax_number": "818-843-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYUR C PATEL MD, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2011-07-26",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MAYUR",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "818-843-5864",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A056296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.