Healthcare Provider Details

I. General information

NPI: 1275268716
Provider Name (Legal Business Name): U.D. ALPHA PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 08/15/2022
Certification Date: 08/15/2022
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 STE AB
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 TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. DINESH PATEL
Title or Position: PRESIDENT/ PHARMACIST IN CHARGE
Credential: RPH
Phone: 714-821-8959