Provider Demographics
NPI:1427648054
Name:ROZEMA, BRIAN THOMAS (PHARMD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:THOMAS
Last Name:ROZEMA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 S MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2286
Mailing Address - Country:US
Mailing Address - Phone:831-422-5988
Mailing Address - Fax:831-422-5999
Practice Address - Street 1:1212 S MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2286
Practice Address - Country:US
Practice Address - Phone:831-422-5988
Practice Address - Fax:831-422-5999
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43402183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA43402OtherCA STATE BOARD OF PHARMACY, REGISTERED PHARMACIST