Healthcare Provider Details

I. General information

NPI: 1265836415
Provider Name (Legal Business Name): MIRAL A. KUMBHANI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MIRAL M PATEL

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W CENTER STREET PROMENADE
ANAHEIM CA
92805-3960
US

IV. Provider business mailing address

200 W CENTER STREET PROMENADE
ANAHEIM CA
92805-3960
US

V. Phone/Fax

Practice location:
  • Phone: 555-555-5555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH80216
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: