Provider Demographics
NPI:1427028703
Name:BORSKEY, WILBUR LAWRENCE (MD)
Entity Type:Individual
Prefix:MR
First Name:WILBUR
Middle Name:LAWRENCE
Last Name:BORSKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25800 CARLOS BEE BLVD
Mailing Address - Street 2:CALIFORNIA STATE UNIVERSITY EAST BAY
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94542-3060
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25800 CARLOS BEE BLVD
Practice Address - Street 2:CALIFORNIA STATE UNIVERSITY EAST BAY
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94542-3060
Practice Address - Country:US
Practice Address - Phone:510-885-3735
Practice Address - Fax:510-885-3230
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG22110208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G22100Medicaid