Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | A40664 | CA |
Y | 207KA0200X | Allergist | A40664 | CA |
N | 207R00000X | Internist | A40664 | CA |
N | 111NI0900X | Internist | A40664 | CA |
NPI | 1396734547 |
---|---|
Provider Name | Dr. Amit I Patel |
First Address | Upland, CA 91786-5183 |
Second Address | Upland, CA 91786-5183 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2005 |
Last Update Date | 31/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A85483 | (02) | CA |