Healthcare Provider Details

I. General information

NPI: 1578530309
Provider Name (Legal Business Name): VIJAY M. PATEL RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 LA SALLE POINTE
CHINO HILLS CA
91709-5112
US

IV. Provider business mailing address

2727 LA SALLE POINTE
CHINO HILLS CA
91709-5112
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 Code183500000X
TaxonomyPharmacist
License NumberRPH 47035
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: