Provider Demographics
NPI:1881691269
Name:PATEL, NISHITA SOMABHAI (MD)
Entity type:Individual
Prefix:
First Name:NISHITA
Middle Name:SOMABHAI
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:795 E. SECOND STREET
Mailing Address - Street 2:SUITE 5
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-2007
Mailing Address - Country:US
Mailing Address - Phone:909-706-8332
Mailing Address - Fax:909-706-3785
Practice Address - Street 1:795 E 2ND ST STE 5
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-2007
Practice Address - Country:US
Practice Address - Phone:909-706-8332
Practice Address - Fax:909-706-3785
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA113143207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADO139YOtherMEDICARE SOUTHERN CALIFORNIA
CADP139ZOtherMEDICARE NORTHERN CALIFORNIA
CAA113143OtherLICENSE