Provider Demographics
NPI:1528070679
Name:PATEL, HIREN R (MD)
Entity type:Individual
Prefix:
First Name:HIREN
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7384 LA VINA TRL
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-2326
Mailing Address - Country:US
Mailing Address - Phone:760-362-3777
Mailing Address - Fax:760-228-2151
Practice Address - Street 1:7384 LA VINA TRL
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-2326
Practice Address - Country:US
Practice Address - Phone:760-362-3777
Practice Address - Fax:760-228-2151
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2014-08-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC50888207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C508880Medicaid
CA00C508880Medicaid