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General NPI Number Information
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NPI Number | 1114003423
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Entity Type | Individual
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Provider Name | NIRMAL L PATEL PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 10/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11201 BENTON ST
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City | LOMA LINDA
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State | CA
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Zip | 92357-1000
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Country | US
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Telephone | 909-825-7084
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Fax |
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Provider Business Mailing Address
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Address Line | 1088 TYLER LN
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City | UPLAND
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State | CA
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Zip | 91784-9279
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Country | US
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Telephone | 909-985-1660
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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 | RPH 55389
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License Number State | CA
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