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General NPI Number Information
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NPI Number | 1245511344
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Entity Type | Individual
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Provider Name | SIPA PRABHA PATEL D.O.
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Gender | Female
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 1263 LAKE PLAZA DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-3564
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Country | US
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Telephone | 719-776-3300
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Fax | 719-776-3329
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Provider Business Mailing Address
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Address Line | 1263 LAKE PLAZA DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-3564
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Country | US
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Telephone | 719-776-3300
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Fax | 719-776-3329
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB09379800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0055610
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License Number State | CO
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