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General NPI Number Information
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NPI Number | 1003600768
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Entity Type | Individual
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Provider Name | ANISH PATHAK PHARMD, MBA
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Gender | Male
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Dates
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Enumeration Date | 04/08/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 2301 FRONTAGE RD E
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City | LITCHFIELD
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State | MN
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Zip | 55355-2625
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Country | US
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Telephone | 320-693-1022
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Fax |
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Provider Business Mailing Address
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Address Line | 4960 OWENS DR APT 723
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City | PLEASANTON
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State | CA
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Zip | 94588-4505
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Country | US
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Telephone | 925-475-9239
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 126848
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License Number State | MN
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