Provider Demographics
NPI:1982646154
Name:PATEL, ANIT B (MD)
Entity Type:Individual
Prefix:
First Name:ANIT
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:855-771-0335
Mailing Address - Fax:
Practice Address - Street 1:2720 LOW CT
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-9771
Practice Address - Country:US
Practice Address - Phone:707-428-2769
Practice Address - Fax:707-436-2507
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA76092207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAV094ZMedicare PIN
CA00A760920Medicare ID - Type Unspecified