Provider Demographics
NPI:1134628712
Name:NORTHERN CALIFORNIA VASECTOMY
Entity type:Organization
Organization Name:NORTHERN CALIFORNIA VASECTOMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHIRAG
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-627-1117
Mailing Address - Street 1:9045 BRUCEVILLE RD STE 100B
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-5950
Mailing Address - Country:US
Mailing Address - Phone:916-627-1117
Mailing Address - Fax:916-226-2656
Practice Address - Street 1:9401 E STOCKTON BLVD STE 130
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-5051
Practice Address - Country:US
Practice Address - Phone:877-628-7647
Practice Address - Fax:877-628-7647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty