Provider Demographics
NPI:1720154909
Name:PATEL, AKSHAI (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:AKSHAI
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 MAIN STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901
Mailing Address - Country:US
Mailing Address - Phone:831-424-8053
Mailing Address - Fax:831-424-4707
Practice Address - Street 1:331 MAIN STREET
Practice Address - Street 2:SUITE A
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901
Practice Address - Country:US
Practice Address - Phone:831-424-8053
Practice Address - Fax:831-424-4707
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPH443240183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA43240Medicaid