Provider Demographics
NPI:1982049821
Name:PATZEK, SOPHIE (MD,)
Entity Type:Individual
Prefix:
First Name:SOPHIE
Middle Name:
Last Name:PATZEK
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W ARBOR DR
Mailing Address - Street 2:# 8422
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-9000
Mailing Address - Country:US
Mailing Address - Phone:619-543-6268
Mailing Address - Fax:619-543-6529
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:# 8422
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9000
Practice Address - Country:US
Practice Address - Phone:619-543-6268
Practice Address - Fax:619-543-6529
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA131954207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism