Provider Demographics
NPI:1194746842
Name:PATEL, HEMANT DAHYABHAI (MD)
Entity type:Individual
Prefix:DR
First Name:HEMANT
Middle Name:DAHYABHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1968 N GAREY AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2753
Mailing Address - Country:US
Mailing Address - Phone:909-620-3858
Mailing Address - Fax:909-620-6167
Practice Address - Street 1:1968 N GAREY AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2753
Practice Address - Country:US
Practice Address - Phone:909-620-3858
Practice Address - Fax:909-620-6167
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51751207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A517511Medicaid
CAA51751Medicare ID - Type Unspecified
CA00A517511Medicaid