| Doctor Name: | MR. CARL EDISON BORDERS |
| NPI Number: | 1770719478 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CCC-SLP/L |
| License Number: | SP11420 |
| Business Practice Address: | 1724 Speyer Ln Redondo Beach, CA - 902784730 |
| Business Phone Number: | 3109717416 |
| Business Fax Number: | |
| Mailing Address: | 1724 Speyer Ln, REDONDO BEACH |
| State: | CA |
| Postal Code: | 902784730 |
| Phone Number: | 3109717416 |
| Fax Number: | |
| NPI Enumeration Date: | 06/08/2009 |
| NPI Last Update Date: | 06/08/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP11420 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |