Provider Demographics
NPI:1033469614
Name:PATEL, KANDARP D (R PH)
Entity Type:Individual
Prefix:MR
First Name:KANDARP
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S 99TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-9706
Mailing Address - Country:US
Mailing Address - Phone:602-382-5499
Mailing Address - Fax:602-382-5386
Practice Address - Street 1:14806 N DEL WEBB BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-2146
Practice Address - Country:US
Practice Address - Phone:602-266-0021
Practice Address - Fax:602-266-0068
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS012443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist