Provider Demographics
NPI:1124472311
Name:BORJON, AGUSTIN JR (MD)
Entity type:Individual
Prefix:DR
First Name:AGUSTIN
Middle Name:
Last Name:BORJON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2130 CITRACADO PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-4151
Mailing Address - Country:US
Mailing Address - Phone:510-314-7180
Mailing Address - Fax:760-739-7633
Practice Address - Street 1:2130 CITRACADO PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-4151
Practice Address - Country:US
Practice Address - Phone:510-314-7180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1968622086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery