Provider Demographics
NPI:1720089329
Name:PATEL, SHEILA A (MD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:A
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 1:7093 HERON CIR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-3975
Mailing Address - Country:US
Mailing Address - Phone:760-814-2045
Mailing Address - Fax:
Practice Address - Street 1:4002 VISTA WAY
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4506
Practice Address - Country:US
Practice Address - Phone:760-814-2045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI43833207Q00000X
CAA55639208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI78B99BROtherATRIUM COMMERCIAL
WIHP67023OtherHEALTH PARTNERS
WI13047OtherDEAN HEALTH PLAN
WI2104049OtherFIRST HEALTH
WI39092953816OtherUNITY - HILLSBORO CLINIC
WI080181679OtherRAILROAD MEDICARE
WI1038474OtherPHYSICIAN'S PLUS
WI34140700Medicaid
WI2026OtherMMSI
WI39092953811OtherUNITY - ELROY CLINIC
WI8918066P01OtherCIGNA
WI2026OtherMMSI
WI39092953811OtherUNITY - ELROY CLINIC
WI78B99BROtherATRIUM COMMERCIAL
WI39092953816OtherUNITY - HILLSBORO CLINIC