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Licensing details for: A 208257

Name: Patel, Antikkumar Maheshbhai

License Type: Physician and Surgeon A

Primary Status: License Renewed & Current Primary Status Definition

Secondary Status: Probationary License Limits On PracticePrimary Status Definition

Probation Summary: Applicant agreed to the issuance of a probationary license based on being convicted of one misdemeanor count of driving with a blood alcohol content of .08% or more with the special allegation of driving with a blood alcohol of .15% or higher; and using drugs and/or alcohol in a manner as to be dangerous or injurious to Applicant, another person, or to the public. Effective 03/24/2026, probationary license issued and placed on five years' probation until anticipated end date of 03/23/2031. Terms and conditions include, but are not limited to, submitting to biological fluid testing; notification of employer; attending substance abuse support group meetings; obtaining a worksite monitor; abstaining from the use of controlled substances; abstaining from the use of alcohol; attending psychotherapy; submitting proof of notification of Decision to required parties; prohibited from supervising physician assistants and advanced practice nurses; submitting quarterly declarations of compliance with all conditions of probation; complying with the Board's probation unit; prohibited from engaging in the practice of medicine in Applicant's or patient's place of residence, unless the patient resides in a skilled nursing facility or other similar licensed facility; and paying costs associated with probation monitoring.

School Name: St. George's University School of Medicine

Graduation Year: 2022

Previous Names: Patel, Antikkumar

Address of Record

1820 Via Petirrojo
Apt F
THOUSAND OAKS CA 91320-5952
VENTURA county
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Issuance Date

March 24, 2026

Expiration Date

May 31, 2028

Current Date / Time

April 8, 2026
7:59:27 PM

Public Record Actions

Public Documents

License Relationships

Postgraduate Training License associated with Physician & Surgeon License

License/Registration Role: Physician & Surgeon

Related Party Role: Postgraduate Training License

Name: Patel, Antikkumar Maheshbhai

License/Registration Type: Postgraduate Training License

License Number: 11333 Primary Status: License Canceled

Address :
1712 E Thousand Oaks Blvd Apt 209
THOUSAND OAKS CA 91362-2968
VENTURA COUNTY

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Survey Information

The following information is self-reported by the licensee and has not been verified by the Board.

No AB 133 Survey Information Provided by Licensee

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