Provider Demographics
NPI:1285089979
Name:PATEL, BHAVESH B (PHARM D)
Entity type:Individual
Prefix:
First Name:BHAVESH
Middle Name:B
Last Name:PATEL
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 1:6215 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2179
Mailing Address - Country:US
Mailing Address - Phone:951-781-0146
Mailing Address - Fax:951-781-0816
Practice Address - Street 1:6215 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2179
Practice Address - Country:US
Practice Address - Phone:951-781-0146
Practice Address - Fax:951-781-0816
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53615183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist