Provider Demographics
NPI:1124152764
Name:PATEL, KAMAL A (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KAMAL
Middle Name:A
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2844 HAMNER AVE
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-1929
Mailing Address - Country:US
Mailing Address - Phone:951-734-1668
Mailing Address - Fax:
Practice Address - Street 1:2844 HAMNER AVE
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-1929
Practice Address - Country:US
Practice Address - Phone:951-734-1668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist