MEDICARE: DR. SHWETA PATEL M.D.

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	207RN0300X	Nephrology Physician	A133003	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255566063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHWETA PATEL M.D.

Provider Business Mailing Address
First Line	:	401 BICENTENNIAL WAY
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-2149
Country	:	US
Telephone Number	:	707-393-4194
Fax Number	:	707-393-4008

Provider Business Practice Location Address
First Line	:	401 BICENTENNIAL WAY
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-2149
Country	:	US
Telephone Number	:	707-393-4194
Fax Number	:	707-393-4008

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

Provider Enumeration Date	:	05/22/2009
Last Update Date	:	12/27/2025

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