Provider Demographics
NPI:1720672199
Name:PATEL, SHREYA CHANDRAKANT (RPH)
Entity type:Individual
Prefix:
First Name:SHREYA
Middle Name:CHANDRAKANT
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 1:33975 DATE PALM DR
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-4736
Mailing Address - Country:US
Mailing Address - Phone:760-202-3533
Mailing Address - Fax:
Practice Address - Street 1:33975 DATE PALM DR
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-4736
Practice Address - Country:US
Practice Address - Phone:760-202-3533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83863183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist