Individual
BUSHRAH PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A
Contact information
Practice address
1422 KELLOGG AVE, CORONA, CA 92879-2911
(951) 588-4278
Mailing address
1422 KELLOGG AVE, CORONA, CA 92879-2911
(951) 588-4278
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
52436
CA
Other
Enumeration date
12/28/2012
Last updated
10/08/2021
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