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General NPI Number Information
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NPI Number | 1235429747
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Entity Type | Individual
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Provider Name | SIMA PATEL PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/18/2011
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Last Update Date | 08/28/2012
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Provider Practice Location Address
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Address Line | 401 S LINCOLN AVE SUITE A
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City | CORONA
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State | CA
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Zip | 92882-7139
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Country | US
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Telephone | 951-372-0010
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Fax |
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Provider Business Mailing Address
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Address Line | 401 S. LINCOLN AVE SUITE A
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City | CORONA
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State | CA
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Zip | 92879
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Country | US
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Telephone | 951-372-0010
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 21547
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License Number State | CA
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