Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | E4704 | CA |
NPI | 1184828675 |
---|---|
Provider Name | Dr. Nirav Subodh Patel |
First Address | Encinitas, CA 92024-3606 |
Second Address | San Marcos, CA 92078-4201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2007 |
Last Update Date | 04/11/2021 |