MEDICARE: UMABEN PATEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	208000000X	Pediatrics Physician	A165818	CA

General Provider Information

NPI Number	:	1336643030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UMABEN PATEL

Provider Business Mailing Address
First Line	:	7910 FROST ST STE 280
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-2752
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7910 FROST ST STE 280
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-2752
Country	:	US
Telephone Number	:	323-783-4516
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2018
Last Update Date	:	11/21/2022

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Directions to “ UMABEN PATEL ” Practice Location

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