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General NPI Number Information
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NPI Number | 1710070396
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Entity Type | Organization
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Legal Business Name | RAJNIKANT M PATEL
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 29211 HEATHERCLIFF RD
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City | MALIBU
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State | CA
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Zip | 90265-4145
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Country | US
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Telephone | 310-457-9707
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Fax |
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Provider Business Mailing Address
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Address Line | 29211 HEATHERCLIFF RD
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City | MALIBU
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State | CA
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Zip | 90265-4145
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Country | US
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Telephone | 310-457-9707
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Fax |
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Authorized Official
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Title or Position | OWNER PHARMACIST
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Name | MR. RAJNIKANT M PATEL
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Credential | RPH
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Telephone | 310-457-9707
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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 | 45225
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY41309
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License Number State | CA
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