Provider Demographics
NPI:1427079169
Name:PATEL, JAYESH J (MD)
Entity type:Individual
Prefix:
First Name:JAYESH
Middle Name:J
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1261 TRAVIS BLVD
Mailing Address - Street 2:STE. 320
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-4897
Mailing Address - Country:US
Mailing Address - Phone:707-423-2506
Mailing Address - Fax:707-425-4236
Practice Address - Street 1:1261 TRAVIS BLVD
Practice Address - Street 2:STE. 320
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-4897
Practice Address - Country:US
Practice Address - Phone:707-423-2506
Practice Address - Fax:707-425-4236
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2014-12-29
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Provider Licenses
StateLicense IDTaxonomies
CAA72056207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A720561Medicare PIN
00A720560Medicare PIN
H52693Medicare UPIN