Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | A71957 | CA |
NPI | 1093884538 |
---|---|
Provider Name | Dr. Tushar Pratap Patel |
First Address | Fountain Valley, CA 92708-4092 |
Second Address | Fountain Valley, CA 92708-4092 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H40221 | (02) | CA |