Provider Demographics
NPI:1245681964
Name:PATEL, HARSHAD S
Entity type:Individual
Prefix:
First Name:HARSHAD
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W KERN AVE
Mailing Address - Street 2:
Mailing Address - City:MC FARLAND
Mailing Address - State:CA
Mailing Address - Zip Code:93250-1360
Mailing Address - Country:US
Mailing Address - Phone:661-792-2198
Mailing Address - Fax:
Practice Address - Street 1:205 W. KERN AVENUE
Practice Address - Street 2:
Practice Address - City:MCFARLAND
Practice Address - State:CA
Practice Address - Zip Code:93250
Practice Address - Country:US
Practice Address - Phone:661-792-2198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH46173183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist