Healthcare Provider Details

I. General information

NPI: 1477348852
Provider Name (Legal Business Name): DR. MITSU PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1570 7TH ST
SANGER CA
93657-2402
US

IV. Provider business mailing address

1170 SANTA ANA AVE APT 178
CLOVIS CA
93612-4057
US

V. Phone/Fax

Practice location:
  • Phone: 559-875-0557
  • Fax:
Mailing address:
  • Phone: 626-780-9093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS112998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: