Provider Demographics
NPI:1053586800
Name:PATEL, BINOY GOVINDBHAI (PTMSPT, OCS)
Entity type:Individual
Prefix:
First Name:BINOY
Middle Name:GOVINDBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:PTMSPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45509 BIRCH CT
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-6816
Mailing Address - Country:US
Mailing Address - Phone:760-271-0548
Mailing Address - Fax:
Practice Address - Street 1:29798 HAUN RD STE 201
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92586
Practice Address - Country:US
Practice Address - Phone:951-679-8500
Practice Address - Fax:951-679-8522
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA346122251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT346120OtherBLUE SHIELD OF CALIFORNIA
CA0PT346120OtherBLUE SHIELD OF CALIFORNIA
CA0PT346120Medicare PIN
CAAS548YMedicare PIN