Healthcare Provider Details

I. General information

NPI: 1821068461
Provider Name (Legal Business Name): JAMES DAVID BOREL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 W HAPPY VALLEY RD STE 141-623
GLENDALE AZ
85310-3292
US

IV. Provider business mailing address

3820 W HAPPY VALLEY RD STE 141-623
GLENDALE AZ
85310-3292
US

V. Phone/Fax

Practice location:
  • Phone: 602-741-9087
  • Fax: 623-580-6944
Mailing address:
  • Phone: 602-741-9087
  • Fax: 623-580-6944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number11909
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: