Healthcare Provider Details

I. General information

NPI: 1962373209
Provider Name (Legal Business Name): AMAN SUNIL PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4234 RIVERWALK PKWY STE 230
RIVERSIDE CA
92505-3312
US

IV. Provider business mailing address

4234 RIVERWALK PKWY STE 230
RIVERSIDE CA
92505-3312
US

V. Phone/Fax

Practice location:
  • Phone: 951-373-5826
  • Fax:
Mailing address:
  • Phone: 951-373-5826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number95033593
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: