Provider Demographics
NPI:1003600768
Name:PATHAK, ANISH (PHARMD, MBA)
Entity type:Individual
Prefix:DR
First Name:ANISH
Middle Name:
Last Name:PATHAK
Suffix:
Gender:
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4960 OWENS DR APT 723
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4505
Mailing Address - Country:US
Mailing Address - Phone:925-475-9239
Mailing Address - Fax:
Practice Address - Street 1:2301 FRONTAGE RD E
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55355-2625
Practice Address - Country:US
Practice Address - Phone:320-693-1022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN126848183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist