Provider Demographics
NPI:1730556150
Name:PATEL, DAVE UMESH (PHARMD)
Entity type:Individual
Prefix:MR
First Name:DAVE
Middle Name:UMESH
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 1:1240 S MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-5116
Mailing Address - Country:US
Mailing Address - Phone:714-220-0373
Mailing Address - Fax:714-220-1462
Practice Address - Street 1:1240 S MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-5116
Practice Address - Country:US
Practice Address - Phone:714-220-0373
Practice Address - Fax:714-220-1462
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70775183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist