Provider Demographics
NPI:1801322524
Name:PATEL, RIPAL RAJESHBHAI
Entity type:Individual
Prefix:MRS
First Name:RIPAL
Middle Name:RAJESHBHAI
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 N TRACY BLVD
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-1721
Mailing Address - Country:US
Mailing Address - Phone:209-836-2316
Mailing Address - Fax:
Practice Address - Street 1:3320 N TRACY BLVD
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-1721
Practice Address - Country:US
Practice Address - Phone:209-836-2316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72105183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist