Provider Demographics
NPI:1699726760
Name:PATEL, SUNIL K (MD)
Entity type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3390 UNIVERSITY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-3315
Mailing Address - Country:US
Mailing Address - Phone:844-827-8000
Mailing Address - Fax:951-335-0058
Practice Address - Street 1:3390 UNIVERSITY AVE STE 100
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3315
Practice Address - Country:US
Practice Address - Phone:844-827-8000
Practice Address - Fax:951-335-0058
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51068208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1811166218Medicaid
CA1699726760Medicaid
CAZZZ43253ZOtherBS/TRIWEST
CAF76457Medicare UPIN