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General NPI Number Information
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NPI Number | 1316833510
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Entity Type | Individual
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Provider Name | GIAN CARLO ALFONSO BORJA DINO
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Gender | Male
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 121 DEKALB AVE
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City | BROOKLYN
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State | NY
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Zip | 11201-5493
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Country | US
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Telephone | 323-717-5105
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Fax |
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Provider Business Mailing Address
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Address Line | 3412 CHAPMAN ST APT 20
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City | LOS ANGELES
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State | CA
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Zip | 90065-2374
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 90286
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03444896
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License Number State | OH
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