Healthcare Provider Details

I. General information

NPI: 1326338237
Provider Name (Legal Business Name): TELEHEALTH SPECIALTY MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2011
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 DOUGLAS BLVD STE 225
ROSEVILLE CA
95661-4283
US

IV. Provider business mailing address

3400 DOUGLAS BLVD STE 170
ROSEVILLE CA
95661-4281
US

V. Phone/Fax

Practice location:
  • Phone: 916-740-3721
  • Fax: 916-783-0513
Mailing address:
  • Phone: 916-740-3721
  • Fax: 916-783-0513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: RAVI PATEL
Title or Position: OWNER
Credential: DO
Phone: 800-792-5972