Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | A89777 | CA |
NPI | 1073516860 |
---|---|
Provider Name | Sheela Thakor Patel |
First Address | Lake Forest, CA 92630-3770 |
Second Address | San Francisco, CA 94117-1018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 08/07/2007 |