Provider Demographics
NPI:1245515824
Name:PATEL, MRUNALBEN D (RPH)
Entity type:Individual
Prefix:MRS
First Name:MRUNALBEN
Middle Name:D
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 RILEY ST
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3511
Mailing Address - Country:US
Mailing Address - Phone:916-983-5862
Mailing Address - Fax:916-983-5894
Practice Address - Street 1:1080 SARATOGA AVE STE 3
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-3418
Practice Address - Country:US
Practice Address - Phone:408-519-2278
Practice Address - Fax:408-519-2272
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-14
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH56727183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist