Provider Demographics
NPI:1629883822
Name:PATEL, RAJAN SUNNY (PHARMD)
Entity type:Individual
Prefix:
First Name:RAJAN
Middle Name:SUNNY
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15059 SANDALWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-2674
Mailing Address - Country:US
Mailing Address - Phone:909-465-3729
Mailing Address - Fax:
Practice Address - Street 1:550 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-4211
Practice Address - Country:US
Practice Address - Phone:626-857-0633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90605183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist