Healthcare Provider Details

I. General information

NPI: 1447652011
Provider Name (Legal Business Name): SHEETAL PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2014
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 VILLA LA JOLLA DR
LA JOLLA CA
92037-1714
US

IV. Provider business mailing address

8950 VILLA LA JOLLA DR
LA JOLLA CA
92037-1714
US

V. Phone/Fax

Practice location:
  • Phone: 619-270-8688
  • Fax:
Mailing address:
  • Phone: 619-270-8688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHY55909
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: