Organization
SIDDHAYE CORPORATION
Active
Other names
MEDICAL PLAZA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MEETA PATEL (OWNER)
(951) 247-3501
Entity
Organization
Contact information
Practice address
12818 HEACOCK ST, STE C 5, MORENO VALLEY, CA 92553-3173
(951) 247-3501
(951) 243-1702
Mailing address
12818 HEACOCK ST, STE C 5, MORENO VALLEY, CA 92553-3173
(951) 247-3501
(951) 243-1702
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY45473
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0563177
NCPDP PROVIDER IDENTIFICATION NUMBER
—
01
—
1982773834
NPI
—
05
—
PHA454730
—
CA
Enumeration date
11/07/2006
Last updated
09/19/2023
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