Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | A156300 | CA |
NPI | 1730574518 |
---|---|
Provider Name | Caitlin Suzanne Borkowski |
First Address | Loma Linda, CA 92354-2804 |
Second Address | Loma Linda, CA 92354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2015 |
Last Update Date | 26/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1730574518 | (05) | FL |