Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | A43865 | CA |
NPI | 1033106562 |
---|---|
Provider Name | Giribala R Patel |
First Address | Fullerton, CA 92835-3826 |
Second Address | Fullerton, CA 92835-3826 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 09/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F57173 | (02) | CA |