Provider Demographics
NPI:1770799660
Name:PATEL, CHANDRAHAS B (MD)
Entity type:Individual
Prefix:DR
First Name:CHANDRAHAS
Middle Name:B
Last Name:PATEL
Suffix:
Gender:
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:6120 W BELL RD
Mailing Address - Street 2:STE 130
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3782
Mailing Address - Country:US
Mailing Address - Phone:623-239-4624
Mailing Address - Fax:623-594-2252
Practice Address - Street 1:6120 W BELL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3781
Practice Address - Country:US
Practice Address - Phone:623-512-4326
Practice Address - Fax:623-584-6732
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KYC09522086S0129X, 208G00000X
OH35.088356173000000X
ND195102086S0129X
SC87379208G00000X
AZ414602086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No173000000XOther Service ProvidersLegal Medicine
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ426381Medicaid
Z161012Medicare PIN