Provider Demographics
NPI:1992087191
Name:KAPADIA, ABDUL M (RPH)
Entity type:Individual
Prefix:MR
First Name:ABDUL
Middle Name:M
Last Name:KAPADIA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:MARTY
Other - Middle Name:M
Other - Last Name:KAPADIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:100 W ONTARIO AVE
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-5215
Mailing Address - Country:US
Mailing Address - Phone:951-582-9551
Mailing Address - Fax:951-493-6762
Practice Address - Street 1:100 W ONTARIO AVE
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-5215
Practice Address - Country:US
Practice Address - Phone:951-582-9551
Practice Address - Fax:951-493-6762
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA433971835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist