Provider Demographics
NPI:1114243854
Name:PATEL, KINJAL
Entity Type:Individual
Prefix:
First Name:KINJAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 S SHORE CTR # 250
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-8073
Mailing Address - Country:US
Mailing Address - Phone:510-323-4410
Mailing Address - Fax:510-694-0776
Practice Address - Street 1:2217 S SHORE CTR # 250
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-8073
Practice Address - Country:US
Practice Address - Phone:510-323-4410
Practice Address - Fax:510-694-0776
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA255133207RN0300X
CA139955207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology