Provider Demographics
NPI:1861532392
Name:PATEL, TASNEEM (DO)
Entity type:Individual
Prefix:
First Name:TASNEEM
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 GROSSMONT BLVD STE 4-7
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-4047
Mailing Address - Country:US
Mailing Address - Phone:619-786-0597
Mailing Address - Fax:
Practice Address - Street 1:8900 GROSSMONT BLVD STE 4-7
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-4047
Practice Address - Country:US
Practice Address - Phone:619-786-0597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A8581207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine