Doctor Name: | BRADLEY BORSARI |
NPI Number: | 1104826619 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | A76554B |
Business Practice Address: | 2141 N Harbor Blvd Suite 25000 Fullerton, CA - 928353827 |
Business Phone Number: | 7146268610 |
Business Fax Number: | 7146268655 |
Mailing Address: | 279 Imperial Hwy, Suite 730 FULLERTON |
State: | CA |
Postal Code: | 928351041 |
Phone Number: | 7144494841 |
Fax Number: | 7144494956 |
NPI Enumeration Date: | 07/26/2005 |
NPI Last Update Date: | 04/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | A76554B |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |