Provider Demographics
NPI:1992946255
Name:PATEL, PAYAL DEVANG (PHARM D)
Entity type:Individual
Prefix:DR
First Name:PAYAL
Middle Name:DEVANG
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:PAYAL
Other - Middle Name:SHAILESH
Other - Last Name:VAKIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:8080 PARKWAY DR
Mailing Address - Street 2:KAISER PERMANENTE, PHARMACY
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-2104
Mailing Address - Country:US
Mailing Address - Phone:951-907-3393
Mailing Address - Fax:815-346-6626
Practice Address - Street 1:8080 PARKWAY DR
Practice Address - Street 2:KAISER PERMANENTE, PHARMACY
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2104
Practice Address - Country:US
Practice Address - Phone:951-907-3393
Practice Address - Fax:815-346-6626
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57269183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist