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NPI Code Detail

MEDICARE: MR. SANJAY SHANTIBHAI PATEL B.S. PHARMACIST

MEDICARE: MR. SANJAY SHANTIBHAI PATEL B.S. PHARMACIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist48629CA
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist48629CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629350731
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SANJAY SHANTIBHAI PATEL B.S. PHARMACIST
Provider Business Mailing Address
First Line : 2600 MOWRY AVE
Second Line :
City : FREMONT
State : CA
Zip : 94538-1619
Country : US
Telephone Number : 510-742-9356
Fax Number : 510-742-9386
Provider Business Practice Location Address
First Line : 37323 FREMONT BLVD
Second Line :
City : FREMONT
State : CA
Zip : 94536-3702
Country : US
Telephone Number : 510-797-2772
Fax Number : 510-797-4986
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2011
Last Update Date : 11/05/2024

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