Provider Demographics
NPI:1881994937
Name:PATEL, AMIT DASHRATH (PHARM D)
Entity type:Individual
Prefix:MR
First Name:AMIT
Middle Name:DASHRATH
Last Name:PATEL
Suffix:
Gender:M
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 1:27800 MEDICAL CENTER RD. SUITE 99
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691
Mailing Address - Country:US
Mailing Address - Phone:949-364-0122
Mailing Address - Fax:949-347-0544
Practice Address - Street 1:27800 MEDICAL CENTER RD. # 99
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-364-0122
Practice Address - Fax:949-347-0544
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-22
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist