Provider Demographics
NPI:1184906562
Name:VITHALANI, DHAVAL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DHAVAL
Middle Name:
Last Name:VITHALANI
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 1:630 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRAWLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92227-2548
Mailing Address - Country:US
Mailing Address - Phone:760-344-6303
Mailing Address - Fax:760-344-6321
Practice Address - Street 1:630 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-2548
Practice Address - Country:US
Practice Address - Phone:760-344-6303
Practice Address - Fax:760-344-6321
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65828183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist