Provider Demographics
NPI:1750663613
Name:PATEL, MINAL S (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MINAL
Middle Name:S
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 1:4070 S EL CAMINO REAL
Mailing Address - Street 2:WALGREENS PHARMACY
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-4537
Mailing Address - Country:US
Mailing Address - Phone:650-212-4600
Mailing Address - Fax:
Practice Address - Street 1:4070 S EL CAMINO REAL
Practice Address - Street 2:WALGREENS PHARMACY
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-4537
Practice Address - Country:US
Practice Address - Phone:650-212-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA48314183500000X
CTCT7811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist