Provider Demographics
NPI:1962420752
Name:PATEL, SANDHYA T (MD)
Entity type:Individual
Prefix:
First Name:SANDHYA
Middle Name:T
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5855 OLIVAS PARK DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7672
Mailing Address - Country:US
Mailing Address - Phone:805-667-2801
Mailing Address - Fax:805-667-2865
Practice Address - Street 1:124 N BRENT ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2810
Practice Address - Country:US
Practice Address - Phone:805-641-9880
Practice Address - Fax:805-641-9890
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA94036207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A3458400Medicaid
CA0271020001Medicare NSC
CAH52891Medicare UPIN
CA00A3458400Medicaid