Provider Demographics
NPI:1710171434
Name:PATEL, GITANE (MD)
Entity Type:Individual
Prefix:DR
First Name:GITANE
Middle Name:
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 1:6945 EL CAJON BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-1754
Mailing Address - Country:US
Mailing Address - Phone:619-697-4600
Mailing Address - Fax:619-697-2410
Practice Address - Street 1:6945 EL CAJON BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-1754
Practice Address - Country:US
Practice Address - Phone:619-697-4600
Practice Address - Fax:619-697-2410
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008012513207W00000X
CAA108603207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology