MEDICARE: DR. ELAINE BORSETH DC

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	111N00000X	Chiropractor	DC18338	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC18338	OTHER	CA	LICENSE NUMBER

General Provider Information

NPI Number	:	1952484313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELAINE BORSETH DC

Provider Business Mailing Address
First Line	:	4849 RONSON CT
Second Line	:	#100
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1805
Country	:	US
Telephone Number	:	858-576-8181
Fax Number	:

Provider Business Practice Location Address
First Line	:	4849 RONSON CT
Second Line	:	#100
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1805
Country	:	US
Telephone Number	:	858-576-8181
Fax Number	:

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

Provider Enumeration Date	:	10/21/2006
Last Update Date	:	09/30/2013

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