Provider Demographics
NPI:1891881462
Name:ZALA, BHARATSINH J (RPH)
Entity Type:Individual
Prefix:
First Name:BHARATSINH
Middle Name:J
Last Name:ZALA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 W ALONDRA BLVD
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220
Mailing Address - Country:US
Mailing Address - Phone:310-631-8674
Mailing Address - Fax:310-631-8673
Practice Address - Street 1:1410 W ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220
Practice Address - Country:US
Practice Address - Phone:310-631-8674
Practice Address - Fax:310-631-8673
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH35367183500000X
CAPHY41569183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA415690Medicaid
CAPHA415690Medicaid