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General NPI Number Information
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NPI Number | 1295121978
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Entity Type | Organization
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Legal Business Name | DR SUNIL PATEL
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Dates
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Enumeration Date | 04/09/2015
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 1470 BESSIE AVE
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City | TRACY
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State | CA
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Zip | 95376-3417
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Country | US
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Telephone | 209-833-0525
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Fax | 209-830-7361
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Provider Business Mailing Address
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Address Line | 1470 BESSIE AVE
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City | TRACY
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State | CA
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Zip | 95376-3417
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Country | US
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Telephone | 209-833-0525
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Fax | 209-830-7361
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUNIL H PATEL
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Credential | M.D.
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Telephone | 209-833-0525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | A43957
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A43957
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License Number State | CA
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