Healthcare Provider Details

I. General information

NPI: 1598386047
Provider Name (Legal Business Name): PUJA PATEL RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PUJA ASHVIN PATEL RPH

II. Dates (important events)

Enumeration Date: 05/06/2020
Last Update Date: 05/28/2021
Certification Date: 05/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9090 WILSHIRE BLVD STE 200
BEVERLY HILLS CA
90211-1850
US

IV. Provider business mailing address

9090 WILSHIRE BLVD
BEVERLY HILLS CA
90211-1848
US

V. Phone/Fax

Practice location:
  • Phone: 310-967-7602
  • Fax: 310-285-7237
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number78076
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: