Healthcare Provider Details

I. General information

NPI: 1235717372
Provider Name (Legal Business Name): NEIL PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6699 ALVARADO RD STE 2100
SAN DIEGO CA
92120-5238
US

IV. Provider business mailing address

6699 ALVARADO RD STE 2100
SAN DIEGO CA
92120-5238
US

V. Phone/Fax

Practice location:
  • Phone: 619-229-3920
  • Fax:
Mailing address:
  • Phone: 619-229-3920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License NumberA208348
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: