Provider Demographics
NPI:1497368682
Name:VALLABH, DIMPLE NIMAL (PHARMD)
Entity Type:Individual
Prefix:
First Name:DIMPLE
Middle Name:NIMAL
Last Name:VALLABH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7847 LICHEN DR
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-1074
Mailing Address - Country:US
Mailing Address - Phone:916-733-4535
Mailing Address - Fax:
Practice Address - Street 1:7847 LICHEN DR
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-1074
Practice Address - Country:US
Practice Address - Phone:916-733-4535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist