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General NPI Number Information
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NPI Number | 1508515479
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Entity Type | Organization
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Legal Business Name | DAN BORGSTADT MD INC
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Dates
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Enumeration Date | 03/19/2022
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Last Update Date | 03/19/2022
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Provider Practice Location Address
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Address Line | 255 W HERNDON AVE STE 103
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City | CLOVIS
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State | CA
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Zip | 93612-0381
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Country | US
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Telephone | 559-326-2999
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Fax | 559-326-2988
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Provider Business Mailing Address
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Address Line | 255 W HERNDON AVE STE 103
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City | CLOVIS
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State | CA
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Zip | 93612-0381
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Country | US
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Telephone | 559-326-2999
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Fax | 559-326-2988
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Authorized Official
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Title or Position | AD
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Name | DAN BORGSTADT
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Credential |
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Telephone | 559-326-2999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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