Healthcare Provider Details

I. General information

NPI: 1659540599
Provider Name (Legal Business Name): VALLARI S PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 02/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39700 BOB HOPE DR SUITE 108
RANCHO MIRAGE CA
92270-3267
US

IV. Provider business mailing address

39700 BOB HOPE DR SUITE 108
RANCHO MIRAGE CA
92270-3267
US

V. Phone/Fax

Practice location:
  • Phone: 760-834-3545
  • Fax: 760-834-3546
Mailing address:
  • Phone: 760-834-3545
  • Fax: 760-834-3546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number255589
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA124784
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: