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General NPI Number Information
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NPI Number | 1053688945
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Entity Type | Organization
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Legal Business Name | YOGENDRA B PATEL,MD,INC
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Dates
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Enumeration Date | 11/21/2011
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Last Update Date | 11/21/2011
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Provider Practice Location Address
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Address Line | 12980 FREDERICK ST SUITE J
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City | MORENO VALLEY
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State | CA
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Zip | 92553-5263
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Country | US
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Telephone | 951-924-9300
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Fax | 951-485-0240
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Provider Business Mailing Address
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Address Line | 12980 FREDERICK ST SUITE J
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City | MORENO VALLEY
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State | CA
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Zip | 92553-5263
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Country | US
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Telephone | 951-924-9300
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Fax | 951-485-0240
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Authorized Official
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Title or Position | SECRETARY
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Name | MS. ROSIE LARA
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Credential |
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Telephone | 951-924-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A40908
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License Number State | CA
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