Provider Demographics
NPI:1386727766
Name:BORSETH, DOREEN (DC)
Entity type:Individual
Prefix:DR
First Name:DOREEN
Middle Name:
Last Name:BORSETH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8250 VICKERS ST
Mailing Address - Street 2:SUITE H
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2117
Mailing Address - Country:US
Mailing Address - Phone:858-576-6900
Mailing Address - Fax:858-576-8198
Practice Address - Street 1:8250 VICKERS ST
Practice Address - Street 2:SUITE H
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2117
Practice Address - Country:US
Practice Address - Phone:858-576-6900
Practice Address - Fax:858-576-8198
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16516111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC16516OtherCA LICENSE NUMBER
CADC16516AMedicare ID - Type Unspecified