Provider Demographics
NPI:1245507540
Name:DOSHI, PRIYANKA D
Entity type:Individual
Prefix:
First Name:PRIYANKA
Middle Name:D
Last Name:DOSHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13200 JAMBOREE RD
Mailing Address - Street 2:T-1238
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-2307
Mailing Address - Country:US
Mailing Address - Phone:714-838-7433
Mailing Address - Fax:
Practice Address - Street 1:13200 JAMBOREE RD
Practice Address - Street 2:T-1238
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92602-2307
Practice Address - Country:US
Practice Address - Phone:714-838-7433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65990183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist