Provider Demographics
NPI:1891319059
Name:PATEL, PUNIT S (PA-C)
Entity Type:Individual
Prefix:MR
First Name:PUNIT
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12711 SCREE WAY
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-4566
Mailing Address - Country:US
Mailing Address - Phone:925-999-0998
Mailing Address - Fax:
Practice Address - Street 1:67580 JONES RD
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-6401
Practice Address - Country:US
Practice Address - Phone:760-642-1112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant