Healthcare Provider Details

I. General information

NPI: 1174265672
Provider Name (Legal Business Name): PARTH PATEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3629 VISTA WAY
OCEANSIDE CA
92056-4522
US

IV. Provider business mailing address

7400 E THOMPSON PEAK PKWY
SCOTTSDALE AZ
85255-4109
US

V. Phone/Fax

Practice location:
  • Phone: 760-757-7546
  • Fax:
Mailing address:
  • Phone: 480-324-7220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number20A24977
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: