Provider Demographics
NPI:1528418647
Name:BORJON, LEONEL (PA-C)
Entity Type:Individual
Prefix:
First Name:LEONEL
Middle Name:
Last Name:BORJON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:223 FULLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-5254
Mailing Address - Country:US
Mailing Address - Phone:714-757-0537
Mailing Address - Fax:
Practice Address - Street 1:1815 E LAKE MEAD BLVD STE 317
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7193
Practice Address - Country:US
Practice Address - Phone:702-960-4150
Practice Address - Fax:702-960-4154
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant