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NPI Code Detail

MEDICARE: MARCY FORGEY BORLIK M.D., M.P.H.

MEDICARE:   MARCY FORGEY BORLIK  M.D., M.P.H.
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
12084P0800XPsychiatry Physician222581MA
22084P0800XPsychiatry PhysicianA99995CA

General Provider Information

NPI Number : 1467667824
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCY FORGEY BORLIK M.D., M.P.H.
Provider Business Mailing Address
First Line : 5920 MOSSBANK DR
Second Line :
City : RANCHO PALOS VERDES
State : CA
Zip : 90275-2113
Country : US
Telephone Number : 312-285-9093
Fax Number :
Provider Business Practice Location Address
First Line : 10323 SANTA MONICA BLVD STE 102
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-5056
Country : US
Telephone Number : 213-373-1070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2007
Last Update Date : 09/18/2024

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