Healthcare Provider Details

I. General information

NPI: 1316884000
Provider Name (Legal Business Name): PRACHI PATEL DO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2023 W VISTA WAY STE D
VISTA CA
92083-6030
US

IV. Provider business mailing address

2023 W VISTA WAY STE D
VISTA CA
92083-6030
US

V. Phone/Fax

Practice location:
  • Phone: 619-330-8771
  • Fax: 760-258-4426
Mailing address:
  • Phone: 619-330-8771
  • Fax: 760-258-4426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PRACHI TONI PATEL
Title or Position: PRESIDENT
Credential: DO
Phone: 619-330-8771