Provider Demographics
NPI:1427247931
Name:PATEL, KIRITKUMAR BABUBHAI (MD)
Entity type:Individual
Prefix:DR
First Name:KIRITKUMAR
Middle Name:BABUBHAI
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 1:3144 KNIGHTSBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-8688
Mailing Address - Country:US
Mailing Address - Phone:209-551-3196
Mailing Address - Fax:
Practice Address - Street 1:201 E ORANGEBURG AVE STE E
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-5355
Practice Address - Country:US
Practice Address - Phone:209-522-8881
Practice Address - Fax:209-522-8885
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35277207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A352770Medicaid
CAZZZ1580ZOtherMEDICARE
CA1427247931OtherNPI
CA1750487021OtherNPI 2
1346380961OtherNPI
1346380961OtherNPI
CA00A352773Medicare PIN
CAW15249Medicare PIN
CAZZZ1580ZOtherMEDICARE
CA00A352770Medicaid
CA1427247931OtherNPI
CAZZZ25341ZMedicare PIN