Provider Demographics
NPI:1104844810
Name:PATEL, RASIK A (MD)
Entity type:Individual
Prefix:
First Name:RASIK
Middle Name:A
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3020 BERNAL AVE
Mailing Address - Street 2:STE 110 PMB 3074
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-3444
Mailing Address - Country:US
Mailing Address - Phone:925-367-0641
Mailing Address - Fax:925-964-8003
Practice Address - Street 1:1600 CREEKSIDE DR
Practice Address - Street 2:SUITE 2800
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3444
Practice Address - Country:US
Practice Address - Phone:925-367-0641
Practice Address - Fax:925-964-8003
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2024-05-12
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Provider Licenses
StateLicense IDTaxonomies
CAA48849207RN0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A488491Medicaid
CA00A488491Medicaid
CABP4947618OtherDEA #
CAF39734Medicare UPIN