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General NPI Number Information
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NPI Number | 1801208913
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Entity Type | Individual
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Provider Name | INDU PATEL
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Gender | Female
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Dates
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Enumeration Date | 05/22/2014
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Last Update Date | 05/22/2014
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Provider Practice Location Address
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Address Line | 2079 COMPTON AVE STE 102
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City | CORONA
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State | CA
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Zip | 92881-7292
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Country | US
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Telephone | 951-735-9599
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Fax |
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Provider Business Mailing Address
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Address Line | 520 WOODSIDE OAKS APT 1
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City | SACRAMENTO
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State | CA
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Zip | 95825-4835
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Country | US
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Telephone | 714-595-7150
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95000742
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License Number State | CA
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