Healthcare Provider Details

I. General information

NPI: 1235429432
Provider Name (Legal Business Name): KALPESH J PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2011
Last Update Date: 04/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MAIN ST
LIVINGSTON CA
95334-1428
US

IV. Provider business mailing address

3003 WOODSIDE TER
FREMONT CA
94539-8071
US

V. Phone/Fax

Practice location:
  • Phone: 209-394-8416
  • Fax:
Mailing address:
  • Phone: 408-661-3402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number45015
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: