Healthcare Provider Details

I. General information

NPI: 1225000532
Provider Name (Legal Business Name): JIGAR D. PATEL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4060 FOURTH AVE STE 650
SAN DIEGO CA
92103-2121
US

IV. Provider business mailing address

4060 FOURTH AVE STE 650
SAN DIEGO CA
92103-2121
US

V. Phone/Fax

Practice location:
  • Phone: 858-900-9778
  • Fax: 858-900-9380
Mailing address:
  • Phone: 858-900-9778
  • Fax: 858-900-9380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number20A7495
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number20A7495
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: