Provider Demographics
NPI:1245260181
Name:PATEL, RAJENDRA B (MD)
Entity type:Individual
Prefix:DR
First Name:RAJENDRA
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14708 PIPELINE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-1296
Mailing Address - Country:US
Mailing Address - Phone:909-393-8585
Mailing Address - Fax:909-393-8566
Practice Address - Street 1:14708 PIPELINE AVE STE B
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-1296
Practice Address - Country:US
Practice Address - Phone:909-393-8585
Practice Address - Fax:909-393-8566
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA383542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA38354AMedicare ID - Type Unspecified
CAC35491Medicare UPIN