MEDICARE: DR. SIRI J PATEL M.D

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	208000000X	Pediatrics Physician	A148531	CA
2	208000000X	Pediatrics Physician	25MA10115000	NJ
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1427475649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIRI J PATEL M.D

Provider Business Mailing Address
First Line	:	8975 BALBOA AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1507
Country	:	US
Telephone Number	:	858-499-2701
Fax Number	:	858-262-8668

Provider Business Practice Location Address
First Line	:	8975 BALBOA AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1507
Country	:	US
Telephone Number	:	858-499-2701
Fax Number	:	858-262-8668

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

Provider Enumeration Date	:	03/26/2014
Last Update Date	:	02/23/2026

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