Provider Demographics
NPI:1255046983
Name:PATEL, PARESHKUMAR G (SPECIALIST ASSISTANT)
Entity type:Individual
Prefix:MR
First Name:PARESHKUMAR
Middle Name:G
Last Name:PATEL
Suffix:
Gender:M
Credentials:SPECIALIST ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4805 MALLARD CMN
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-2829
Mailing Address - Country:US
Mailing Address - Phone:508-915-1418
Mailing Address - Fax:
Practice Address - Street 1:4805 MALLARD CMN
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94555-2829
Practice Address - Country:US
Practice Address - Phone:508-915-1418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000256246ZX2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant