Provider Demographics
NPI:1447373857
Name:ZALAVADIYA, RAJESH B (RPH)
Entity type:Individual
Prefix:
First Name:RAJESH
Middle Name:B
Last Name:ZALAVADIYA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 W BARBARA WORTH DR APT 29
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-2129
Mailing Address - Country:US
Mailing Address - Phone:760-352-4656
Mailing Address - Fax:
Practice Address - Street 1:405 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-2244
Practice Address - Country:US
Practice Address - Phone:760-344-3131
Practice Address - Fax:760-344-6772
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 57055183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist