Healthcare Provider Details

I. General information

NPI: 1326359092
Provider Name (Legal Business Name): RITA P PATEL RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2010
Last Update Date: 06/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 CORTE MADERA TOWN CTR
CORTE MADERA CA
94925-1215
US

IV. Provider business mailing address

431 CORTE MADERA TOWN CTR
CORTE MADERA CA
94925-1215
US

V. Phone/Fax

Practice location:
  • Phone: 415-924-4557
  • Fax: 415-924-8111
Mailing address:
  • Phone: 415-924-4557
  • Fax: 415-924-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60979
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: