| Doctor Name: | MS. IMELDA ANCHETA BORJA |
| NPI Number: | 1588972442 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA19669 |
| Business Practice Address: | 22844 Virginia Blvd California City, CA - 93505 |
| Business Phone Number: | 7603731764 |
| Business Fax Number: | |
| Mailing Address: | 1837 E 215th Pl, CARSON |
| State: | CA |
| Postal Code: | 907451857 |
| Phone Number: | 3105497341 |
| Fax Number: | |
| NPI Enumeration Date: | 09/14/2010 |
| NPI Last Update Date: | 09/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA19669 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |