Provider Demographics
NPI:1447694690
Name:PATEL, RUJU DILIP
Entity type:Individual
Prefix:
First Name:RUJU
Middle Name:DILIP
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 CELEBRATION CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-2600
Mailing Address - Country:US
Mailing Address - Phone:408-386-1683
Mailing Address - Fax:
Practice Address - Street 1:619 CELEBRATION CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95134-2600
Practice Address - Country:US
Practice Address - Phone:408-386-1683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2014-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52889183500000X
NJ28RI03557000183500000X
CA70593183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist