Basic Information
| Provider Information | |||||||||
| NPI: | 1891702734 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | NANDLAL | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2810 CAMINO DEL RIO S STE 102 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921083819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192991419 | ||||||||
| FaxNumber: | 8584616008 | ||||||||
| Practice Location | |||||||||
| Address1: | 2810 CAMINO DEL RIO S STE 102 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921083819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192991419 | ||||||||
| FaxNumber: | 8584616008 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2006 | ||||||||
| LastUpdateDate: | 05/24/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | C156676 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.