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General NPI Number Information
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NPI Number | 1205571734
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Entity Type | Organization
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Legal Business Name | KUNJ GOVIND PATEL MD PC
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Dates
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Enumeration Date | 04/29/2022
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Last Update Date | 04/29/2022
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Provider Practice Location Address
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Address Line | 95 W 11TH ST STE 10395W11
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City | TRACY
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State | CA
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Zip | 95376-3959
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Country | US
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Telephone | 415-754-3549
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Fax |
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Provider Business Mailing Address
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Address Line | DPT 2110 20500 BELSHAW AVE
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City | CARSON
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State | CA
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Zip | 90746-3506
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Country | US
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Telephone | 415-754-3549
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KUNJ GOVIND PATEL
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Credential | MD
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Telephone | 314-282-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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