Healthcare Provider Details

I. General information

NPI: 1881130854
Provider Name (Legal Business Name): RUPAL PATEL PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2017
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39400 PASEO PADRE PKWY
FREMONT CA
94538-2310
US

IV. Provider business mailing address

39400 PASEO PADRE PKWY
FREMONT CA
94538-2310
US

V. Phone/Fax

Practice location:
  • Phone: 510-248-3143
  • Fax:
Mailing address:
  • Phone: 510-248-3143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number51714
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: