Healthcare Provider Details

I. General information

NPI: 1538171095
Provider Name (Legal Business Name): RAHUL R. PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10150 SORRENTO VALLEY RD SUITE 320
SAN DIEGO CA
92121-1635
US

IV. Provider business mailing address

10150 SORRENTO VALLEY RD STE 320
SAN DIEGO CA
92121-1614
US

V. Phone/Fax

Practice location:
  • Phone: 858-678-6886
  • Fax:
Mailing address:
  • Phone: 858-784-5645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD00045432
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4301080343
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA97304
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: