Provider Demographics
NPI:1497044713
Name:PARIKH, KAUSHAL
Entity Type:Individual
Prefix:
First Name:KAUSHAL
Middle Name:
Last Name:PARIKH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10681 N TEA PARTY LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-5917
Mailing Address - Country:US
Mailing Address - Phone:213-479-1823
Mailing Address - Fax:
Practice Address - Street 1:6720 N FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-3743
Practice Address - Country:US
Practice Address - Phone:213-479-1823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2017-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 57309183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist