Provider Demographics
NPI:1104162544
Name:PATEL, DARSHANA (PHARMD)
Entity type:Individual
Prefix:
First Name:DARSHANA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10990 WARNER AVE STE A
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-3849
Mailing Address - Country:US
Mailing Address - Phone:714-962-7200
Mailing Address - Fax:
Practice Address - Street 1:10990 WARNER AVE STE A
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3849
Practice Address - Country:US
Practice Address - Phone:714-962-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59857183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA59857OtherPHARMACIST CALIFORNIA STATE LICENSE NUMBER