Provider Demographics
NPI:1932940723
Name:BORSADIA, CHIRAG
Entity type:Individual
Prefix:
First Name:CHIRAG
Middle Name:
Last Name:BORSADIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2341 JUNE MOUNTAIN CT
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-4289
Mailing Address - Country:US
Mailing Address - Phone:541-331-5307
Mailing Address - Fax:
Practice Address - Street 1:2341 JUNE MOUNTAIN CT
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-4289
Practice Address - Country:US
Practice Address - Phone:541-331-5307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA89537183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist