Provider Demographics
NPI:1295799104
Name:PATEL, DIPA H (MD)
Entity type:Individual
Prefix:DR
First Name:DIPA
Middle Name:H
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15195 NATIONAL AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2631
Mailing Address - Country:US
Mailing Address - Phone:408-800-5247
Mailing Address - Fax:408-356-5526
Practice Address - Street 1:15195 NATIONAL AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2631
Practice Address - Country:US
Practice Address - Phone:408-800-5247
Practice Address - Fax:408-356-5526
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC515182085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0C5151800Medicaid
CAG68375Medicare UPIN
CA0C5151800Medicaid
CA0C5151800Medicare PIN