Provider Demographics
NPI:1427511773
Name:BORECKY, DANIELA MARITZA (MD)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:MARITZA
Last Name:BORECKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:MARITZA
Other - Last Name:ALE-SALVO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1276 AUTO PARK WAY
Mailing Address - Street 2:STE D, PMB #420
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-2200
Mailing Address - Country:US
Mailing Address - Phone:404-922-8177
Mailing Address - Fax:909-265-9463
Practice Address - Street 1:5651 COPLEY DR STE A
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-7903
Practice Address - Country:US
Practice Address - Phone:858-262-6267
Practice Address - Fax:858-262-6779
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2023-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA178275207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine