Provider Demographics
NPI:1801009477
Name:PATEL, MITESH BHULABHAI (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:MITESH
Middle Name:BHULABHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9901
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389-1901
Mailing Address - Country:US
Mailing Address - Phone:661-549-6537
Mailing Address - Fax:661-327-2598
Practice Address - Street 1:2215 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3602
Practice Address - Country:US
Practice Address - Phone:661-632-5504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG080844207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG13707Medicare UPIN