Provider Demographics
NPI:1700184157
Name:PATEL, SHYAM RAMESH (DO)
Entity type:Individual
Prefix:DR
First Name:SHYAM
Middle Name:RAMESH
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:8695 SPECTRUM CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1489
Mailing Address - Country:US
Mailing Address - Phone:858-798-9083
Mailing Address - Fax:760-705-1533
Practice Address - Street 1:7901 FROST ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2701
Practice Address - Country:US
Practice Address - Phone:858-939-3400
Practice Address - Fax:858-939-3527
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2024-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB09456900207R00000X
KYTP396208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine