Provider Demographics
NPI:1700950847
Name:PATAKI, GYORGY (MD)
Entity Type:Individual
Prefix:
First Name:GYORGY
Middle Name:
Last Name:PATAKI
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 1:336 BON AIR CTR
Mailing Address - Street 2:#483
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-3017
Mailing Address - Country:US
Mailing Address - Phone:415-378-4143
Mailing Address - Fax:415-329-1741
Practice Address - Street 1:336 BON AIR CTR
Practice Address - Street 2:#483
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-3017
Practice Address - Country:US
Practice Address - Phone:415-378-4143
Practice Address - Fax:415-329-1741
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74189207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H06875Medicare UPIN
01430-0013Medicare ID - Type Unspecified