Healthcare Provider Details
I. General information
NPI: 1245515824
Provider Name (Legal Business Name): MRUNALBEN D PATEL RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/14/2011
Last Update Date: 12/14/2024
Certification Date: 12/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1080 SARATOGA AVE STE 3
SAN JOSE CA
95129-3418
US
IV. Provider business mailing address
1100 RILEY ST
FOLSOM CA
95630-3511
US
V. Phone/Fax
- Phone: 408-519-2278
- Fax: 408-519-2272
- Phone: 916-983-5862
- Fax: 916-983-5894
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | RPH56727 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: