Individual provider Active NPI

Dylan Patrick Boroian, RPH

  • Pharmacist
  • Fresno, CA
National Provider Identifier
1003528415
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
87396 Issued in CA
Practice address
740 W Alluvial Ave Ste 101
Fresno, CA 93711-5509
Phone
(559) 432-9800
NPI assigned
Dec 16, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 87396 CA Primary

Addresses

Primary practice location

740 W Alluvial Ave Ste 101
Fresno, CA 93711-5509

Mailing address

21914 Lakeland Ave
Lake Forest, CA 92630-2431
Phone (949) 533-1194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
87396CAMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1671148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1003528415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21914 LAKELAND AVE",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302431",
            "telephone_number": "949-533-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 W ALLUVIAL AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115509",
            "telephone_number": "559-432-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOROIAN",
        "first_name": "DYLAN",
        "middle_name": "PATRICK",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-16",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "87396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.