Provider Demographics
NPI:1790493583
Name:BORZIN, ROMTIN (RPH)
Entity Type:Individual
Prefix:DR
First Name:ROMTIN
Middle Name:
Last Name:BORZIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43456 LAUREL GLEN CMN
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-5799
Mailing Address - Country:US
Mailing Address - Phone:510-364-1217
Mailing Address - Fax:
Practice Address - Street 1:499 ALVARADO ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2739
Practice Address - Country:US
Practice Address - Phone:831-372-8085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86849183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist