Provider Demographics
NPI:1003259375
Name:PATEL, SONAL KIRTI (PHARMD)
Entity type:Individual
Prefix:
First Name:SONAL
Middle Name:KIRTI
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7824 GIRARD AVE
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4230
Mailing Address - Country:US
Mailing Address - Phone:858-459-4285
Mailing Address - Fax:858-459-9521
Practice Address - Street 1:416 CAMINO HERMOSO
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-8901
Practice Address - Country:US
Practice Address - Phone:949-379-4022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63751183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist