Provider Demographics
NPI:1497043228
Name:PATEL, GITA P (RPH)
Entity Type:Individual
Prefix:MRS
First Name:GITA
Middle Name:P
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7725 N POLK AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-9059
Mailing Address - Country:US
Mailing Address - Phone:559-490-0031
Mailing Address - Fax:559-490-0031
Practice Address - Street 1:7600 N BLACKSTONE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-4300
Practice Address - Country:US
Practice Address - Phone:559-490-0031
Practice Address - Fax:559-490-0031
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45728183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist