Provider Demographics
NPI:1477766152
Name:PATEL, JIJIBHOY JAMES (MD)
Entity Type:Individual
Prefix:MR
First Name:JIJIBHOY
Middle Name:JAMES
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 1:1010 MURRIETA BLVD
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-4111
Mailing Address - Country:US
Mailing Address - Phone:925-245-0177
Mailing Address - Fax:925-999-8190
Practice Address - Street 1:1010 MURRIETA BLVD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4111
Practice Address - Country:US
Practice Address - Phone:925-245-0177
Practice Address - Fax:925-999-8190
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC38717207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C387170Medicaid
A89063Medicare UPIN
CA00C387170Medicaid