Provider Demographics
NPI:1841825585
Name:PATEL, BHUMI KAUSHIK
Entity type:Individual
Prefix:
First Name:BHUMI
Middle Name:KAUSHIK
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5037 SADDLEBACK ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-6539
Mailing Address - Country:US
Mailing Address - Phone:626-272-8611
Mailing Address - Fax:
Practice Address - Street 1:5037 SADDLEBACK ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-6539
Practice Address - Country:US
Practice Address - Phone:626-272-8611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant