Provider Demographics
NPI:1457691388
Name:BORDEN, MORGAN (DO)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:BORDEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:NAKAWATASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:21311 MADRONA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-5970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2601 W ALAMEDA AVE STE 212
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4814
Practice Address - Country:US
Practice Address - Phone:818-847-6990
Practice Address - Fax:818-847-6938
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A14065207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program