Provider Demographics
NPI:1508858903
Name:PATEL, NILESH NAVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:NILESH
Middle Name:NAVIN
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2694 E GARVEY AVE S
Mailing Address - Street 2:#393
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-2113
Mailing Address - Country:US
Mailing Address - Phone:626-914-1514
Mailing Address - Fax:626-914-1505
Practice Address - Street 1:130 WEST ROUTE 66
Practice Address - Street 2:#302
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-6249
Practice Address - Country:US
Practice Address - Phone:626-914-1514
Practice Address - Fax:626-914-1505
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA66234207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA954815847OtherBLUECROSS OF CALIFORNIA
CA00A662340OtherBLUE SHIELD OF CALIFORNIA
CA954815847OtherUNITED HEALTHCARE
CA00A662349Medicaid
CA440003351OtherRAILROAD MEDICARE
CA954815847OtherTAX IDENTIFICATION NUMBER
CA440003351OtherRAILROAD MEDICARE
CAA66234Medicare ID - Type Unspecified