Provider Demographics
NPI:1811208630
Name:PATEL, DAKSHA S (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DAKSHA
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 1:13660 WHITEWOOD CYN
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-1351
Mailing Address - Country:US
Mailing Address - Phone:858-842-1010
Mailing Address - Fax:858-486-3328
Practice Address - Street 1:12666 POWAY RD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-4416
Practice Address - Country:US
Practice Address - Phone:858-486-0851
Practice Address - Fax:858-486-3328
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist