Provider Demographics
NPI:1548715428
Name:PATEL, RAJESH JIVRAJ
Entity type:Individual
Prefix:
First Name:RAJESH
Middle Name:JIVRAJ
Last Name:PATEL
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 1:3800 ROSEDALE HWY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-6235
Mailing Address - Country:US
Mailing Address - Phone:661-852-2642
Mailing Address - Fax:661-862-2663
Practice Address - Street 1:3800 ROSEDALE HWY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-6235
Practice Address - Country:US
Practice Address - Phone:661-852-2642
Practice Address - Fax:661-862-2663
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH52738183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist