Provider Demographics
NPI:1437225174
Name:PATEL, SUMAN N (MD)
Entity Type:Individual
Prefix:
First Name:SUMAN
Middle Name:N
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6850 SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 217
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-4444
Mailing Address - Country:US
Mailing Address - Phone:818-901-7855
Mailing Address - Fax:818-901-1915
Practice Address - Street 1:6850 SEPULVEDA BLVD
Practice Address - Street 2:SUITE 217
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4444
Practice Address - Country:US
Practice Address - Phone:818-901-7855
Practice Address - Fax:818-901-1915
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2022-02-07
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Provider Licenses
StateLicense IDTaxonomies
CAA36682207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A363820Medicaid
CAA36382OtherMEDICARE ID
CA00A363820Medicaid