Basic Information
| Provider Information | |||||||||
| NPI: | 1407225139 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | BHADRAKSH | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11713 COVENT GARDENS DR | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933119241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6617030486 | ||||||||
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| Practice Location | |||||||||
| Address1: | 655 S CENTRAL VALLEY HWY | ||||||||
| Address2: | |||||||||
| City: | SHAFTER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932632790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003006664 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2015 | ||||||||
| LastUpdateDate: | 09/23/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | RPH 47228 | CA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.