Provider Demographics
NPI:1164750915
Name:BORNA, SOLANGE MICHELLE (DPT)
Entity Type:Individual
Prefix:MISS
First Name:SOLANGE
Middle Name:MICHELLE
Last Name:BORNA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9675 BRIGHTON WAY STE 422
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5139
Mailing Address - Country:US
Mailing Address - Phone:310-274-9307
Mailing Address - Fax:
Practice Address - Street 1:9675 BRIGHTON WAY STE 422
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5139
Practice Address - Country:US
Practice Address - Phone:310-274-9307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA339962251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic