Provider Demographics
NPI:1275284929
Name:TZENG, JEVIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEVIN
Middle Name:
Last Name:TZENG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:898 S KALISPELL CIR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-2080
Mailing Address - Country:US
Mailing Address - Phone:501-339-7431
Mailing Address - Fax:
Practice Address - Street 1:16375 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80023-8907
Practice Address - Country:US
Practice Address - Phone:303-474-3254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0023689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist