Provider Demographics
NPI:1912978834
Name:RAVI PATEL M.D. INC
Entity Type:Organization
Organization Name:RAVI PATEL M.D. INC
Other - Org Name:COMPREHENSIVE BLOOD & CANCER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PRADIP
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-862-7112
Mailing Address - Street 1:6501 TRUXTUN AVENUE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309
Mailing Address - Country:US
Mailing Address - Phone:661-322-2206
Mailing Address - Fax:661-327-7027
Practice Address - Street 1:6501 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0633
Practice Address - Country:US
Practice Address - Phone:661-322-2206
Practice Address - Fax:661-327-7027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42045174400000X
CAG85497174400000X
CAA86993174400000X
CAA69648174400000X
CAA53049174400000X
CAA32177174400000X
CAA33989174400000X
CAA52158174400000X
CAOT3382174400000X
CAA30749174400000X
CAA41572174400000X
CAA71636174400000X
CAA51899174400000X
CA25135174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0397590001Medicare NSC
CAZZZ23873ZMedicare PIN
CAW21262Medicare PIN