Individual
DR. JAGDISH A PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
644 W 12TH ST, TRACY, CA 95376-3437
(209) 832-8984
(209) 832-8988
Mailing address
644 W 12TH ST, TRACY, CA 95376-3437
(209) 832-8984
(209) 832-8988
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
A31816
CA
2083X0100X
Occupational Medicine Physician
A31816
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A31816
LICENSE NUMBER
CA
Enumeration date
06/09/2006
Last updated
03/07/2023
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