Provider Demographics
NPI:1417299421
Name:PATEL, BHAVANA (RPH)
Entity type:Individual
Prefix:MRS
First Name:BHAVANA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11000 HILAIRE BLAISE DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3706
Mailing Address - Country:US
Mailing Address - Phone:661-477-5476
Mailing Address - Fax:661-847-0181
Practice Address - Street 1:9508 STOCKDALE HWY STE 130
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3623
Practice Address - Country:US
Practice Address - Phone:661-664-7979
Practice Address - Fax:661-847-0181
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH41641183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist