Provider Demographics
NPI:1528513439
Name:PATEL, NITIN (RPH)
Entity type:Individual
Prefix:
First Name:NITIN
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 GRAND AVE
Mailing Address - Street 2:#130
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-6800
Mailing Address - Country:US
Mailing Address - Phone:909-364-9244
Mailing Address - Fax:909-364-9222
Practice Address - Street 1:2140 GRAND AVE
Practice Address - Street 2:#130
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-6800
Practice Address - Country:US
Practice Address - Phone:909-364-9244
Practice Address - Fax:909-364-9222
Is Sole Proprietor?:No
Enumeration Date:2016-08-20
Last Update Date:2016-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44125183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist