Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 17900 | CA |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 17900 | CA |
NPI | 1184809733 |
---|---|
Provider Name | Rita Patel |
First Address | Loma Linda, CA 92354-2803 |
Second Address | Loma Linda, CA 92354-2803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2008 |
Last Update Date | 10/07/2012 |