Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 25MA09229200 | NJ |
Y | 2080P0216X | Pediatric Rheumatologist | A124934 | CA |
NPI | 1639420540 |
---|---|
Provider Name | Dr. Reshma Patel |
First Address | Madera, CA 93636-8761 |
Second Address | Madera, CA 93636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2012 |
Last Update Date | 10/07/2019 |