Provider Demographics
NPI:1710264395
Name:PARIKH, JAY NITIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:NITIN
Last Name:PARIKH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 SAN PABLO ST
Mailing Address - Street 2:SUITE 144
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-5320
Mailing Address - Country:US
Mailing Address - Phone:323-442-6120
Mailing Address - Fax:323-442-5970
Practice Address - Street 1:1510 SAN PABLO ST
Practice Address - Street 2:SUITE 144
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5320
Practice Address - Country:US
Practice Address - Phone:323-442-6120
Practice Address - Fax:323-442-5970
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65714183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA65714OtherPHARMACIST LICENSE