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NPI Code Detail

MEDICARE: PAVAN PATEL

MEDICARE: PAVAN PATEL
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
1183500000XPharmacist72575CA

General Provider Information

NPI Number : 1710460357
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAVAN PATEL
Provider Business Mailing Address
First Line : 4550 MERIDIAN AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95124-4828
Country : US
Telephone Number : 408-267-1472
Fax Number :
Provider Business Practice Location Address
First Line : 1405 FOXWORTHY AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95118-1119
Country : US
Telephone Number : 408-264-0371
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2018
Last Update Date : 12/08/2020

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Directions to “ PAVAN PATEL ” Practice Location

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