Provider Demographics
NPI:1952060212
Name:PATEL, VISHAL (PHARMD)
Entity Type:Individual
Prefix:
First Name:VISHAL
Middle Name:
Last Name:PATEL
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 1:18292 JOEL BRATTAIN DR
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-6120
Mailing Address - Country:US
Mailing Address - Phone:916-595-7408
Mailing Address - Fax:
Practice Address - Street 1:15141 WHITTIER BLVD STE 115
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2160
Practice Address - Country:US
Practice Address - Phone:562-273-5222
Practice Address - Fax:562-273-5358
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-14
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61642183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist