MEDICARE: DR. DANIELLE L BORUT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	G19737	CA
2	2080P0205X	Pediatric Endocrinology Physician	G19737	CA

General Provider Information

NPI Number	:	1407884562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIELLE L BORUT M.D.

Provider Business Mailing Address
First Line	:	1701 CESAR E. CHAVEZ AVE
Second Line	:	SUITE 532
City	:	LOS ANGELES
State	:	CA
Zip	:	90033
Country	:	US
Telephone Number	:	323-987-1200
Fax Number	:	323-987-1212

Provider Business Practice Location Address
First Line	:	1700 E CESAR E CHAVEZ AVE
Second Line	:	SUITE 3000
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-2424
Country	:	US
Telephone Number	:	323-987-1200
Fax Number	:	323-987-1212

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	08/23/2022

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Directions to “ DR. DANIELLE L BORUT M.D.” Practice Location

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