Provider Demographics
NPI:1548692973
Name:PADSHALA, MEHUL NANUBHAI
Entity type:Individual
Prefix:DR
First Name:MEHUL
Middle Name:NANUBHAI
Last Name:PADSHALA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34119 MILAT ST
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-5504
Mailing Address - Country:US
Mailing Address - Phone:256-335-1835
Mailing Address - Fax:
Practice Address - Street 1:1111 E WASHINGTON AVE STE C
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-2226
Practice Address - Country:US
Practice Address - Phone:760-755-7880
Practice Address - Fax:760-755-7882
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64364183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist