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General NPI Number Information
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NPI Number | 1104252188
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Entity Type | Individual
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Provider Name | SHUSHMA PATEL R.PH.,MBA
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Gender | Female
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Dates
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Enumeration Date | 09/23/2013
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Last Update Date | 09/23/2013
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Provider Practice Location Address
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Address Line | 1215 W WHITTIER BLVD
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City | MONTEBELLO
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State | CA
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Zip | 90640-4642
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Country | US
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Telephone | 323-728-8127
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Fax |
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Provider Business Mailing Address
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Address Line | 1215 W.WHITTIER BLVD
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City | MONTEBELLO
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State | CA
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Zip | 90640-4697
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Country | US
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Telephone | 323-728-8127
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 45967
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License Number State | CA
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