Healthcare Provider Details

I. General information

NPI: 1346376894
Provider Name (Legal Business Name): SONAL RAMESH PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 12/22/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 E GREEN ST STE 108
PASADENA CA
91106-2401
US

IV. Provider business mailing address

3236 EMERALD ISLE DR
GLENDALE CA
91206-1110
US

V. Phone/Fax

Practice location:
  • Phone: 626-793-6680
  • Fax: 888-475-7784
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA80378
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberA80378
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: