Provider Demographics
NPI:1891702734
Name:PATEL, NANDLAL M (MD)
Entity Type:Individual
Prefix:
First Name:NANDLAL
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2810 CAMINO DEL RIO S STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3819
Mailing Address - Country:US
Mailing Address - Phone:619-299-1419
Mailing Address - Fax:858-461-6008
Practice Address - Street 1:2810 CAMINO DEL RIO S STE 102
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3819
Practice Address - Country:US
Practice Address - Phone:619-299-1419
Practice Address - Fax:858-461-6008
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC156676207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine