Healthcare Provider Details

I. General information

NPI: 1518848225
Provider Name (Legal Business Name): KRINA V PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18612 SANTA ANA AVE
BLOOMINGTON CA
92316-2636
US

IV. Provider business mailing address

4164 BROCKTON AVE
RIVERSIDE CA
92501-3400
US

V. Phone/Fax

Practice location:
  • Phone: 909-421-7120
  • Fax: 909-421-7128
Mailing address:
  • Phone: 951-683-5193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: