Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E4559 | CA |
Y | 222Z00000X | Podiatrist | E4559 | CA |
NPI | 1023154622 |
---|---|
Provider Name | Gitanjali J. Patel |
First Address | Concord, CA 94520-2026 |
Second Address | Concord, CA 94520-2026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 02/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E45591 | PTAN (01) | CA |