Provider Demographics
NPI:1992768519
Name:PATEL, RAKESH R (MD)
Entity type:Individual
Prefix:
First Name:RAKESH
Middle Name:R
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 1:940 LUNDY LN
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-5940
Mailing Address - Country:US
Mailing Address - Phone:608-347-3405
Mailing Address - Fax:408-358-2793
Practice Address - Street 1:15400 NATIONAL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2433
Practice Address - Country:US
Practice Address - Phone:408-358-8400
Practice Address - Fax:408-358-2793
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1052892085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I12683Medicare UPIN
ZZZ34390ZMedicare PIN