Basic Information
| Provider Information | |||||||||
| NPI: | 1902130305 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | RAJAN | ||||||||
| MiddleName: | H. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25775 MCBEAN PKWY | ||||||||
| Address2: | SUITE 215 | ||||||||
| City: | VALENCIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913553708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6617535464 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 25775 MCBEAN PKWY | ||||||||
| Address2: | SUITE 215 | ||||||||
| City: | VALENCIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913553708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6617535464 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2009 | ||||||||
| LastUpdateDate: | 03/10/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | R70201 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 14112 | NV | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | A113726 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | A113726 | CA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 12273450 | 01 | CAQH | OTHER |