Healthcare Provider Details

I. General information

NPI: 1164001665
Provider Name (Legal Business Name): DEEP KAMLESH PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2021
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 C ST STE 1500
SACRAMENTO CA
95816-3371
US

IV. Provider business mailing address

4860 Y ST STE 3800
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-7463
  • Fax: 916-734-6493
Mailing address:
  • Phone: 916-734-5885
  • Fax: 916-734-7904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberA206703
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: