Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | RDH32434 | CA |
NPI | 1003389198 |
---|---|
Provider Name | Neelam Patel |
First Address | Garden Grove, CA 92840-3147 |
Second Address | Garden Grove, CA 92840-3147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2019 |
Last Update Date | 10/01/2019 |