Healthcare Provider Details

I. General information

NPI: 1851463871
Provider Name (Legal Business Name): SHAILESH PATEL MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 EASTON DR SUITE 102
BAKERSFIELD CA
93309-9427
US

IV. Provider business mailing address

PO BOX 21240
BAKERSFIELD CA
93390-1240
US

V. Phone/Fax

Practice location:
  • Phone: 661-633-0400
  • Fax: 661-633-0401
Mailing address:
  • Phone: 661-633-0400
  • Fax: 661-633-0401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA63416
License Number StateCA

VIII. Authorized Official

Name: SHAILESH C. PATEL
Title or Position: PRESIDENT
Credential:
Phone: 661-633-0400