Provider Demographics
NPI:1356611784
Name:KAPADIA, ROOPA (MPHARM)
Entity type:Individual
Prefix:
First Name:ROOPA
Middle Name:
Last Name:KAPADIA
Suffix:
Gender:F
Credentials:MPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 POINTVIEW LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94806-1999
Mailing Address - Country:US
Mailing Address - Phone:510-223-3725
Mailing Address - Fax:
Practice Address - Street 1:13751 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3701
Practice Address - Country:US
Practice Address - Phone:510-233-9467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-02
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64308183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA60444OtherWALGREENS