MEDICARE: SMITA PATEL PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	48531	CA
2	183500000X	Pharmacist	12602	NV
3	183500000X	Pharmacist	20054	MD

General Provider Information

NPI Number	:	1982066445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SMITA PATEL PHARMD

Provider Business Mailing Address
First Line	:	16961 BEACH BLVD
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-4808
Country	:	US
Telephone Number	:	714-841-3951
Fax Number	:

Provider Business Practice Location Address
First Line	:	16961 BEACH BLVD
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-4808
Country	:	US
Telephone Number	:	714-841-3951
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2016
Last Update Date	:	03/24/2016

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Directions to “ SMITA PATEL PHARMD” Practice Location

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