Provider Demographics
NPI:1235113036
Name:LABORDA, OSCAR (MD)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:
Last Name:LABORDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 350
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-0350
Mailing Address - Country:US
Mailing Address - Phone:215-723-2333
Mailing Address - Fax:215-723-9112
Practice Address - Street 1:1088 W BALTIMORE PIKE
Practice Address - Street 2:SUITE 2407
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063
Practice Address - Country:US
Practice Address - Phone:610-565-1808
Practice Address - Fax:610-892-9535
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016384E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00000315032 06OtherUNITED HEALTH CARE
PA0000673779OtherBOEING BLUE SHIELD
PA0031422000OtherKEYSTONE HEALTHPLAN EAST
PA1334935OtherCIGNA
PA0030907OtherAETNA US HEALTHCARE
PA0031422000OtherAMERIHEALTH
PA0000161491OtherINDEPENDENCE BLUE CROSS
PA0000673779OtherHORIZON BLUE SHIELD
PA0000161491OtherBLAIR MILL
PA0007274050003Medicaid
PA0031422000OtherPERSONAL CHOICE
PA1334935OtherCIGNA
PA0031422000OtherKEYSTONE HEALTHPLAN EAST