MEDICARE: DR. TRUSHYAP RAVAJIBHAI PATEL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	D-50969	CA

General Provider Information

NPI Number	:	1033177860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRUSHYAP RAVAJIBHAI PATEL DDS

Provider Business Mailing Address
First Line	:	2279 WICKLOW ST
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96001-6001
Country	:	US
Telephone Number	:	530-242-9266
Fax Number	:	530-242-9266

Provider Business Practice Location Address
First Line	:	2147 COURT ST
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96001-2531
Country	:	US
Telephone Number	:	530-246-4100
Fax Number	:	530-246-4266

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	12/13/2013

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