Healthcare Provider Details

I. General information

NPI: 1780642314
Provider Name (Legal Business Name): ALKA BAKUL PATEL M.D.-PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 11/22/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MUIR RD
MARTINEZ CA
94553-4668
US

IV. Provider business mailing address

6030 PALERMO WAY
EL DORADO HILLS CA
95762-5423
US

V. Phone/Fax

Practice location:
  • Phone: 707-437-1983
  • Fax:
Mailing address:
  • Phone: 916-358-5684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA 92032
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA 92032
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: