Provider Demographics
NPI:1366998536
Name:PATEL, ALPA
Entity type:Individual
Prefix:
First Name:ALPA
Middle Name:
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 1:28781 LOS ALISOS BLVD
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-4984
Mailing Address - Country:US
Mailing Address - Phone:949-595-0501
Mailing Address - Fax:949-595-0513
Practice Address - Street 1:28781 LOS ALISOS BLVD
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-4984
Practice Address - Country:US
Practice Address - Phone:949-595-0501
Practice Address - Fax:949-595-0513
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist