Provider Demographics
NPI:1346203973
Name:PATEL, SURENDRA MOTIBHAI (MD)
Entity Type:Individual
Prefix:
First Name:SURENDRA
Middle Name:MOTIBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SURENDRA
Other - Middle Name:MOTIBHAI
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5680 N FRESNO ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8331
Mailing Address - Country:US
Mailing Address - Phone:559-440-1110
Mailing Address - Fax:559-440-1114
Practice Address - Street 1:5680 N FRESNO ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8331
Practice Address - Country:US
Practice Address - Phone:559-440-1110
Practice Address - Fax:559-440-1114
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50956207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine