Healthcare Provider Details

I. General information

NPI: 1497450621
Provider Name (Legal Business Name): PATEL, D.O., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 CHADBOURNE ROAD STE A11
FAIRFIELD CA
94534
US

IV. Provider business mailing address

802 E WHITING ST STE 14
TAMPA FL
33602-4136
US

V. Phone/Fax

Practice location:
  • Phone: 415-906-2273
  • Fax: 866-582-2948
Mailing address:
  • Phone: 415-906-2273
  • Fax: 866-582-2948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RAVI PATEL
Title or Position: OWNER/MEDICAL DIRECTOR
Credential: DO
Phone: 888-900-4776