Provider Demographics
NPI:1164531430
Name:PATEL, ARUN CHANDRA KANT (MD)
Entity Type:Individual
Prefix:MR
First Name:ARUN
Middle Name:CHANDRA KANT
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 J ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3631
Mailing Address - Country:US
Mailing Address - Phone:916-454-6191
Mailing Address - Fax:916-454-1036
Practice Address - Street 1:3939 J ST
Practice Address - Street 2:SUITE 106
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3631
Practice Address - Country:US
Practice Address - Phone:916-454-6191
Practice Address - Fax:916-454-1036
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42740207W00000X, 207WX0107X
NV6973207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A427400OtherBLUE SHIELD
WA0199833OtherDEPT. OF LABOR WASHINGTON
CA00A427400Medicaid
CA180009835OtherRAILROAD MEDICARE
CA180009835OtherRAILROAD MEDICARE
WA0199833OtherDEPT. OF LABOR WASHINGTON
CA00A427400OtherBLUE SHIELD
CA00A427404Medicare PIN
CA00A427400Medicare PIN
C35543Medicare UPIN
CA00A427403Medicare PIN
CA00A4274010Medicare PIN
CA00A427401Medicare PIN