Provider Demographics
NPI:1073516860
Name:PATEL, SHEELA THAKOR (MD)
Entity Type:Individual
Prefix:
First Name:SHEELA
Middle Name:THAKOR
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23889 GOWDY AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-3770
Mailing Address - Country:US
Mailing Address - Phone:949-699-0960
Mailing Address - Fax:
Practice Address - Street 1:1 SHRADER ST
Practice Address - Street 2:STE 600
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1018
Practice Address - Country:US
Practice Address - Phone:415-750-5797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA897772086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery