Individual
NISHA A PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1100 VAN NESS AVE, SAN FRANCISCO, CA 94109-6978
(415) 600-3458
(415) 558-7020
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(415) 600-3458
(415) 558-7020
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A11705
CA
208M00000X
Hospitalist Physician
Primary
20A11705
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A11705
STATE MEDICAL LICENSE
CA
01
—
GM858Z
MEDICARE
CA
Enumeration date
06/25/2009
Last updated
04/08/2021
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