Provider Demographics
NPI:1609844539
Name:PATEL, SARITA PULKIT (MD)
Entity Type:Individual
Prefix:
First Name:SARITA
Middle Name:PULKIT
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CHANNING AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2720
Mailing Address - Country:US
Mailing Address - Phone:617-834-1913
Mailing Address - Fax:
Practice Address - Street 1:200 CHANNING AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2720
Practice Address - Country:US
Practice Address - Phone:650-688-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC537412084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM18518OtherBLUE CROSS BLUE SHEILD
MAM18518OtherBLUE CROSS BLUE SHEILD