Provider Demographics
NPI:1720841018
Name:BELTRAN, EMIL VINCENT ZURILLA (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:EMIL VINCENT
Middle Name:ZURILLA
Last Name:BELTRAN
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:DR
Other - First Name:EMILVIN
Other - Middle Name:ZURILLA
Other - Last Name:BELTRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:2288 BOREALIS CIR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-4480
Mailing Address - Country:US
Mailing Address - Phone:224-535-0080
Mailing Address - Fax:
Practice Address - Street 1:2288 BOREALIS CIR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-4480
Practice Address - Country:US
Practice Address - Phone:224-535-0080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH792151835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy