Healthcare Provider Details

I. General information

NPI: 1770088213
Provider Name (Legal Business Name): MONIQUE MUKESH PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 POST ST STE 420
SAN FRANCISCO CA
94115-3466
US

IV. Provider business mailing address

17360 BROOKHURST ST
FOUNTAIN VALLEY CA
92708-3720
US

V. Phone/Fax

Practice location:
  • Phone: 415-885-7886
  • Fax: 415-502-7814
Mailing address:
  • Phone: 714-665-1797
  • Fax: 714-665-4680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA165306
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA165306
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA165306
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberA165306
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: