1205129269 NPI number — DR. MEETA NATVERBHAI PATEL PHARMD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205129269 NPI number — DR. MEETA NATVERBHAI PATEL PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATEL
Provider First Name:
MEETA
Provider Middle Name:
NATVERBHAI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205129269
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2626 COLORADO BLVD
Provider Second Line Business Mailing Address:
TARGET PHARMACY T-1408
Provider Business Mailing Address City Name:
EAGLE ROCK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90041-1070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-258-5101
Provider Business Mailing Address Fax Number:
323-258-5101

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2626 COLORADO BLVD
Provider Second Line Business Practice Location Address:
TARGET PHARMACY T-1408
Provider Business Practice Location Address City Name:
EAGLE ROCK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90041-1070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-258-5101
Provider Business Practice Location Address Fax Number:
323-258-5101
Provider Enumeration Date:
05/25/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RPH 61821 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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