Provider Demographics
NPI:1659340743
Name:PATEL, MILAN CHETAN (MD)
Entity Type:Individual
Prefix:
First Name:MILAN
Middle Name:CHETAN
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 1:4767 SOQUEL DR
Mailing Address - Street 2:
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-2457
Mailing Address - Country:US
Mailing Address - Phone:831-477-9912
Mailing Address - Fax:831-476-2815
Practice Address - Street 1:4767 SOQUEL DR
Practice Address - Street 2:
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-2457
Practice Address - Country:US
Practice Address - Phone:831-477-9912
Practice Address - Fax:831-476-2815
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG82214207R00000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABA456BMedicare PIN