Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | G68939 | CA |
NPI | 1013980481 |
---|---|
Provider Name | Dr. David J. Borge |
First Address | Visalia, CA 93291-6331 |
Second Address | Visalia, CA 93291-5034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 29/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G689390 | (05) | CA |
BW920S | (02) | CA |
E92125 | (02) | CA |