Provider Demographics
NPI:1437281565
Name:PATEL, ATULKUMAR C (MD)
Entity Type:Individual
Prefix:
First Name:ATULKUMAR
Middle Name:C
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 1:6800 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-4162
Mailing Address - Country:US
Mailing Address - Phone:714-995-5400
Mailing Address - Fax:714-995-5254
Practice Address - Street 1:6800 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-4162
Practice Address - Country:US
Practice Address - Phone:714-995-5400
Practice Address - Fax:714-995-5254
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA387032085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA38703OtherCA LICENSE
CAA38703OtherCA LICENSE