Healthcare Provider Details

I. General information

NPI: 1104093343
Provider Name (Legal Business Name): MS. NIMMI PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NIMMI PATEL RPH

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1735 EUCLID AVE
SAN DIEGO CA
92105-5414
US

IV. Provider business mailing address

6540 REFLECTION DR APT#1317
SAN DIEGO CA
92124-5119
US

V. Phone/Fax

Practice location:
  • Phone: 619-264-7211
  • Fax: 619-262-3519
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 59547
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: