Provider Demographics
NPI:1336435635
Name:PATEL, GRISHMA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:GRISHMA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
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 1:562 E DUANE AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-3741
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:95 HOLGER WAY
Practice Address - Street 2:TARGET PHARMACY STORE T2581
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95134-1377
Practice Address - Country:US
Practice Address - Phone:408-834-1528
Practice Address - Fax:408-834-1529
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH-61769183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist