Provider Demographics
NPI:1043688633
Name:PATEL RASOOL, MISBAH (MD)
Entity Type:Individual
Prefix:DR
First Name:MISBAH
Middle Name:
Last Name:PATEL RASOOL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MISBAH
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:21634 RETREAT PKWY
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-6100
Mailing Address - Country:US
Mailing Address - Phone:951-493-6835
Mailing Address - Fax:
Practice Address - Street 1:21634 RETREAT PKWY
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92883-6100
Practice Address - Country:US
Practice Address - Phone:951-493-6835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-13
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA07777535207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine