Provider Demographics
NPI:1649630070
Name:DESAI, SEJAL (PHARM D)
Entity type:Individual
Prefix:
First Name:SEJAL
Middle Name:
Last Name:DESAI
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 1:8621 GARVEY AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-3272
Mailing Address - Country:US
Mailing Address - Phone:626-571-0171
Mailing Address - Fax:
Practice Address - Street 1:1000 E IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-7452
Practice Address - Country:US
Practice Address - Phone:714-869-0539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54791183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist