Basic Information
Provider Information
NPI: 1225292642
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: VISHAL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3835 N FREEWAY BLVD STE 100
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958341954
CountryCode: US
TelephoneNumber: 9165767900
FaxNumber: 9162850338
Practice Location
Address1: 9280 W STOCKTON BLVD STE 230
Address2:  
City: ELK GROVE
State: CA
PostalCode: 957588078
CountryCode: US
TelephoneNumber: 9165767924
FaxNumber: 9166919461
Other Information
ProviderEnumerationDate: 07/15/2008
LastUpdateDate: 03/29/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X252979NYN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
2084P0800XA130093CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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