Provider Demographics
NPI:1104952753
Name:PATEL, SAILESH (PHARMD, FASCP)
Entity type:Individual
Prefix:DR
First Name:SAILESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD, FASCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5520 ELDERBERRY LN
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-5809
Mailing Address - Country:US
Mailing Address - Phone:714-692-6635
Mailing Address - Fax:714-694-1525
Practice Address - Street 1:4709 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-4112
Practice Address - Country:US
Practice Address - Phone:714-633-7700
Practice Address - Fax:714-633-7755
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH42801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist