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General NPI Number Information
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NPI Number | 1700817632
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Entity Type | Individual
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Provider Name | AMIKSHA S PATEL M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3975 JACKSON ST SUITE # 203
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City | RIVERSIDE
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State | CA
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Zip | 92503-3901
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Country | US
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Telephone | 951-689-6889
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Fax | 951-689-6462
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Provider Business Mailing Address
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Address Line | 436 GREEN ORCHARD PL
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City | RIVERSIDE
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State | CA
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Zip | 92506-7590
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Country | US
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Telephone | 951-750-2260
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Fax | 951-689-6462
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | A78581
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | A 78581
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License Number State | CA
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