Provider Demographics
NPI:1265673156
Name:PATEL, DEVAL ACHIT (OD)
Entity Type:Individual
Prefix:
First Name:DEVAL
Middle Name:ACHIT
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2225 E GARVEY AVE N
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-1500
Mailing Address - Country:US
Mailing Address - Phone:626-600-9486
Mailing Address - Fax:951-813-4044
Practice Address - Street 1:2233 E GARVEY AVE N STE A
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1500
Practice Address - Country:US
Practice Address - Phone:626-600-9486
Practice Address - Fax:951-813-4044
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA125256152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU98427Medicare UPIN