Basic Information
| Provider Information | |||||||||
| NPI: | 1295287613 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | CHANDNI | ||||||||
| MiddleName: | MUKESH | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 737 W CHILDS AVE | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953416805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093846493 | ||||||||
| FaxNumber: | 2093831296 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 C PATTERSON | ||||||||
| Address2: | |||||||||
| City: | PATTERSON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2098928441 | ||||||||
| FaxNumber: | 2098925984 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2016 | ||||||||
| LastUpdateDate: | 03/02/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 383418 | OH | N | Nursing Service Providers | Registered Nurse | 163W00000X | 4704310935 | MI | N | Nursing Service Providers | Registered Nurse | 363LF0000X | NP95005761 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.