Healthcare Provider Details

I. General information

NPI: 1316159544
Provider Name (Legal Business Name): DIPIKA PATEL-BOOLANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2375 E CAMELBACK RD STE 600
PHOENIX AZ
85016-3493
US

IV. Provider business mailing address

4330 WORNALL RD SUITE 40
KANSAS CITY MO
64111-3201
US

V. Phone/Fax

Practice location:
  • Phone: 602-551-8052
  • Fax: 602-428-7025
Mailing address:
  • Phone: 816-531-0930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number2011025940
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: