Provider Demographics
NPI:1790860922
Name:PATEL, PRAKASHCHANDRA C (MD)
Entity type:Individual
Prefix:DR
First Name:PRAKASHCHANDRA
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:395 N SAN JACINTO ST
Mailing Address - Street 2:SUITE #B
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-3109
Mailing Address - Country:US
Mailing Address - Phone:951-929-4612
Mailing Address - Fax:951-929-5705
Practice Address - Street 1:395 N SAN JACINTO ST
Practice Address - Street 2:SUITE # B
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3109
Practice Address - Country:US
Practice Address - Phone:951-929-4612
Practice Address - Fax:951-929-5705
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA329952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA322995OtherLICENSE
CA00A329950-09Medicaid
CA00A329950-09Medicaid
CAA27002Medicare UPIN
CA00A329950-09Medicaid