| Patel Pharmacy Clinic | |
|
455 Oconnor Dr Ste 190 San Jose CA 95128-1632 | |
| (408) 298-6198 | |
| (408) 271-1368 |
| Full Name | Patel Pharmacy Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 455 Oconnor Dr Ste 190, San Jose, California |
| Authorized Official Name and Position | Jwalant Patel (OWNER) |
| Authorized Official Contact | 4082986198 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patel Pharmacy Clinic 455 Oconnor Dr Ste 190 San Jose CA 95128-1632 Ph: (408) 298-6198 | Patel Pharmacy Clinic 455 Oconnor Dr Ste 190 San Jose CA 95128-1632 Ph: (408) 298-6198 |
| NPI Number | 1912649856 |
|---|---|
| Provider Enumeration Date | 04/11/2022 |
| Last Update Date | 07/07/2022 |
| Medicare PECOS PAC ID | 3779968201 |
|---|---|
| Medicare Enrollment ID | O20220919002609 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912649856 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Laura Purdy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093058463 PECOS PAC ID: 9133556624 Enrollment ID: I20200403001862 |
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