Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0100X | Gastroenterologist | 036137725 | IL |
Y | 207RG0100X | Gastroenterologist | A163386 | CA |
NPI | 1003178138 |
---|---|
Provider Name | Kumkum Sarkar Patel |
First Address | Fullerton, CA 92835-3616 |
Second Address | Fullerton, CA 92835-3616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2012 |
Last Update Date | 09/11/2021 |