Provider Demographics
NPI:1124894621
Name:BHATT, URV SETUL (PHARM D)
Entity type:Individual
Prefix:
First Name:URV
Middle Name:SETUL
Last Name:BHATT
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 E NORTHRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-2967
Mailing Address - Country:US
Mailing Address - Phone:717-954-9788
Mailing Address - Fax:
Practice Address - Street 1:11975 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2540
Practice Address - Country:US
Practice Address - Phone:717-954-9788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88724183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist