Healthcare Provider Details

I. General information

NPI: 1720841018
Provider Name (Legal Business Name): EMIL VINCENT ZURILLA BELTRAN PHARMD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: EMILVIN ZURILLA BELTRAN PHARMD, RPH

II. Dates (important events)

Enumeration Date: 01/31/2024
Last Update Date: 01/31/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2288 BOREALIS CIR
ROSEVILLE CA
95747-4480
US

IV. Provider business mailing address

2288 BOREALIS CIR
ROSEVILLE CA
95747-4480
US

V. Phone/Fax

Practice location:
  • Phone: 224-535-0080
  • Fax:
Mailing address:
  • Phone: 224-535-0080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRPH79215
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: