Provider Demographics
NPI:1265512131
Name:MARVIN BORSAND PC
Entity Type:Organization
Organization Name:MARVIN BORSAND PC
Other - Org Name:BODY SCULPTING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BORSAND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-464-8000
Mailing Address - Street 1:2255 N SCOTTSDALE RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-2124
Mailing Address - Country:US
Mailing Address - Phone:480-464-8000
Mailing Address - Fax:480-990-2556
Practice Address - Street 1:2255 N SCOTTSDALE RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-2124
Practice Address - Country:US
Practice Address - Phone:480-464-8000
Practice Address - Fax:480-990-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOSC0068261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical