Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 45601 | MA |
Y | 213EG0000X | General Practice | 45601 | MA |
NPI | 1003930181 |
---|---|
Provider Name | Dr. Tim J Patel |
First Address | Walnut Creek, CA 94596 |
Second Address | Walnut Creek, CA 94596-8606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 08/07/2007 |