Provider Demographics
NPI:1306224985
Name:PATEL, SANDEEP (DPM)
Entity Type:Individual
Prefix:DR
First Name:SANDEEP
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1597 LIVE OAK RD APT 67
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-5418
Mailing Address - Country:US
Mailing Address - Phone:760-518-1364
Mailing Address - Fax:
Practice Address - Street 1:1597 LIVE OAK RD
Practice Address - Street 2:APT 67
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-5418
Practice Address - Country:US
Practice Address - Phone:760-518-1364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-14
Last Update Date:2024-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5430213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery