Healthcare Provider Details

I. General information

NPI: 1396772034
Provider Name (Legal Business Name): GIRISH K PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 W 8TH ST STE 109
HANFORD CA
93230-4533
US

IV. Provider business mailing address

PO BOX 580
LEMOORE CA
93245-0580
US

V. Phone/Fax

Practice location:
  • Phone: 559-582-2500
  • Fax: 559-582-0550
Mailing address:
  • Phone: 559-386-4500
  • Fax: 559-282-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA301520
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: