Healthcare Provider Details

I. General information

NPI: 1073589982
Provider Name (Legal Business Name): U.D. ALPHA PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 S BEACH BLVD STE AB
ANAHEIM CA
92804-1812
US

IV. Provider business mailing address

515 S BEACH BLVD A AND B
ANAHEIM CA
92804-1812
US

V. Phone/Fax

Practice location:
  • Phone: 714-821-8959
  • Fax: 714-821-4261
Mailing address:
  • Phone: 714-821-8959
  • Fax: 714-821-4261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0794920001
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHY44181
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY44181
License Number StateCA

VIII. Authorized Official

Name: MR. DINESH R. PATEL
Title or Position: PRESIDENT
Credential: RPH
Phone: 714-821-8959