Individual
POONAM PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3801 MIRANDA AVE, PALO ALTO, CA 94304
(650) 493-5000
Mailing address
3801 MIRANDA AVE, PALO ALTO, CA 94304-1207
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95005624
CA
363LG0600X
Gerontology Nurse Practitioner
95005624
CA
Other
Enumeration date
12/08/2016
Last updated
02/04/2019
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