Provider Demographics
NPI:1114420866
Name:PATEL, KALPESH (RPH)
Entity Type:Individual
Prefix:
First Name:KALPESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 CALLE VIAJERA
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5810
Mailing Address - Country:US
Mailing Address - Phone:510-406-3089
Mailing Address - Fax:
Practice Address - Street 1:7400 MACARTHUR BLVD STE B
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2939
Practice Address - Country:US
Practice Address - Phone:510-638-9851
Practice Address - Fax:510-638-9852
Is Sole Proprietor?:No
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH49167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist