Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 999999 | CA |
NPI | 1760157069 |
---|---|
Provider Name | Dr. Prashanta K Patel |
First Address | San Francisco, CA 94143-2210 |
Second Address | San Francisco, CA 94143-2210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2021 |
Last Update Date | 16/08/2021 |