Provider Demographics
NPI:1508447590
Name:BARTOLOME, ROXANNE PIOL (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:PIOL
Last Name:BARTOLOME
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:883 46TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-3203
Mailing Address - Country:US
Mailing Address - Phone:415-439-3573
Mailing Address - Fax:
Practice Address - Street 1:498 CASTRO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-2020
Practice Address - Country:US
Practice Address - Phone:415-861-3136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67644183500000X
CA84147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist