Provider Demographics
NPI:1881914141
Name:PATEL, DASHRATH S
Entity type:Individual
Prefix:
First Name:DASHRATH
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DASH
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:24420 AVENIDA DE MARCIA
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-4019
Mailing Address - Country:US
Mailing Address - Phone:714-692-0858
Mailing Address - Fax:714-692-0858
Practice Address - Street 1:5560 E SANTA ANA CANYON RD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3124
Practice Address - Country:US
Practice Address - Phone:714-998-4801
Practice Address - Fax:714-998-8549
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 033276183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist