Provider Demographics
NPI:1477223253
Name:PATEL, PARESH (APH-ADVANCE PRACTICE)
Entity Type:Individual
Prefix:DR
First Name:PARESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:APH-ADVANCE PRACTICE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 E CESAR E CHAVEZ AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-2496
Mailing Address - Country:US
Mailing Address - Phone:323-221-6000
Mailing Address - Fax:
Practice Address - Street 1:1701 E CESAR E CHAVEZ AVE STE 109
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-2496
Practice Address - Country:US
Practice Address - Phone:323-221-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH74869183500000X
CAAPH109351835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist