NPI Code Detail JSON Logo

1669669800 NPI number — KIMBERLY BORUCKI LARA D.C

NPI Number: 1669669800
Health Care Provider/Practitioner: KIMBERLY BORUCKI LARA D.C

Information about “1669669800” NPI (KIMBERLY BORUCKI LARA D.C) exists in 1669669800 in HTML format HTML  |  1669669800 in plain Text format TXT  |  1669669800 in PDF (Portable Document Format) PDF  |  1669669800 in an XML format XML  formats.

NPI Number : 1669669800 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669669800",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BORUCKI LARA",
    "FirstName": "KIMBERLY",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "LARA",
    "OtherFirstName": "KIMBERLY",
    "OtherMiddleName": null,
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "DC",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "2735 W UNION HILLS DR",
    "SecondLineMailingAddress": "SUITE 102",
    "MailingAddressCityName": "PHOENIX",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85027-5033",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "602-973-1630",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2735 W UNION HILLS DR",
    "SecondLinePracticeLocationAddress": "SUITE 102",
    "PracticeLocationAddressCityName": "PHOENIX",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85027-5033",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "602-973-1630",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/02/2007",
    "LastUpdateDate": "10/02/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "111N00000X",
        "TaxonomyName": "Chiropractor",
        "LicenseNumber": "5427",
        "LicenseNumberStateCode": "AZ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.