MEDICARE: MR. SUNIL K PATEL RPH

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
1	183500000X	Pharmacist	47902	CA

General Provider Information

NPI Number	:	1952612780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SUNIL K PATEL RPH

Provider Business Mailing Address
First Line	:	13660 WHITEWOOD CYN
Second Line	:
City	:	POWAY
State	:	CA
Zip	:	92064-1351
Country	:	US
Telephone Number	:	858-842-1010
Fax Number	:

Provider Business Practice Location Address
First Line	:	10631 TIERRASANTA BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92124-2605
Country	:	US
Telephone Number	:	858-576-0972
Fax Number	:	858-576-0035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2010
Last Update Date	:	06/25/2010

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