Healthcare Provider Details

I. General information

NPI: 1841692175
Provider Name (Legal Business Name): DHRUV ROHITKUMAR PATEL PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2014
Last Update Date: 09/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42010 WASHINGTON ST
BERMUDA DUNES CA
92203-9610
US

IV. Provider business mailing address

47750 ADAMS ST APT 1126
LA QUINTA CA
92253-7101
US

V. Phone/Fax

Practice location:
  • Phone: 760-772-9122
  • Fax:
Mailing address:
  • Phone: 317-410-0193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number71394
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: