Provider Demographics
NPI:1013263904
Name:MAKADIA, NIRAV H (PHARM D)
Entity type:Individual
Prefix:
First Name:NIRAV
Middle Name:H
Last Name:MAKADIA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 COLEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95110-2047
Mailing Address - Country:US
Mailing Address - Phone:408-346-2023
Mailing Address - Fax:
Practice Address - Street 1:533 COLEMAN AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95110-2047
Practice Address - Country:US
Practice Address - Phone:408-346-2023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68661183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist