Provider Demographics
NPI:1447533112
Name:VITHALANI, DINESH (RPH)
Entity type:Individual
Prefix:MR
First Name:DINESH
Middle Name:
Last Name:VITHALANI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:DENNIS
Other - Middle Name:
Other - Last Name:VITHALANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:630 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRAWLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92227-2548
Mailing Address - Country:US
Mailing Address - Phone:760-344-6303
Mailing Address - Fax:760-344-6321
Practice Address - Street 1:630 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-2548
Practice Address - Country:US
Practice Address - Phone:760-344-6303
Practice Address - Fax:760-344-6321
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH37714183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1710998208OtherNPI# FOR THE PHARMACY VALLEY MEDICAL PHARMACY, 630 MAIN STREET, BRAWLEY, CA 9222