Healthcare Provider Details

I. General information

NPI: 1235106741
Provider Name (Legal Business Name): RAJNISH ARVIND PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 BUTTE ST
REDDING CA
96001-0852
US

IV. Provider business mailing address

3116 W MARCH LN STE200
STOCKTON CA
95219-2370
US

V. Phone/Fax

Practice location:
  • Phone: 530-241-0410
  • Fax:
Mailing address:
  • Phone: 209-473-6555
  • Fax: 209-473-6544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG079246
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: