Provider Demographics
NPI:1952543514
Name:PATEL, BHAVESHKUMAR JAYANTIBHAI (MD)
Entity Type:Individual
Prefix:
First Name:BHAVESHKUMAR
Middle Name:JAYANTIBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BHAVESH
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9481 PITTSBURGH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-9021
Mailing Address - Country:US
Mailing Address - Phone:909-655-0300
Mailing Address - Fax:909-655-1161
Practice Address - Street 1:9481 PITTSBURGH AVE STE 200
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730
Practice Address - Country:US
Practice Address - Phone:909-655-0300
Practice Address - Fax:909-655-1161
Is Sole Proprietor?:No
Enumeration Date:2009-03-29
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117569207RG0100X, 207RG0100X
SD9484207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology