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General NPI Number Information
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NPI Number | 1578326773
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Entity Type | Individual
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Provider Name | TAVISH PATEL
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Gender | Male
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Dates
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Enumeration Date | 02/01/2024
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 1600 CALIFORNIA DR
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City | VACAVILLE
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State | CA
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Zip | 95687-9325
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Country | US
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Telephone | 559-310-8628
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Fax |
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Provider Business Mailing Address
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Address Line | 1480 ARY LN
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City | DIXON
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State | CA
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Zip | 95620-4227
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Country | US
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Telephone | 559-310-8628
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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 | 87746
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License Number State | CA
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