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General NPI Number Information
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NPI Number | 1376728253
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Entity Type | Individual
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Provider Name | NIMA PATEL PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 02/28/2014
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Provider Practice Location Address
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Address Line | 1828 EL CAMINO REAL STE 611
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City | BURLINGAME
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State | CA
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Zip | 94010-3103
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Country | US
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Telephone | 650-696-2431
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Fax | 650-696-3659
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Provider Business Mailing Address
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Address Line | 195 LONDON CT
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City | SAN BRUNO
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State | CA
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Zip | 94066-3905
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Country | US
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Telephone | 650-888-9820
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Fax | 650-876-0861
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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 | 19204
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License Number State | CA
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