Provider Demographics
NPI:1013932912
Name:PATEL, DAYALJIBHAI D (MD)
Entity Type:Individual
Prefix:
First Name:DAYALJIBHAI
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 10097, 865 N ARIZOLA
Mailing Address - Street 2:SUN LIFE FAMILY HEALTH CENTER
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122
Mailing Address - Country:US
Mailing Address - Phone:520-836-3446
Mailing Address - Fax:520-836-8807
Practice Address - Street 1:1856 E. FLORENCE BLVD.
Practice Address - Street 2:SUN LIFE CENTER FOR CHILDREN
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122
Practice Address - Country:US
Practice Address - Phone:520-836-5036
Practice Address - Fax:520-316-0365
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ34184208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ948581Medicaid
AZ948581Medicaid
AZZ120757Medicare PIN