Provider Demographics
NPI:1558921775
Name:BORGSMILLER, ALISON (ALISON)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:
Last Name:BORGSMILLER
Suffix:
Gender:F
Credentials:ALISON
Other - Prefix:MISS
Other - First Name:ALISON
Other - Middle Name:MARIE
Other - Last Name:ROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8525 TASSAJARA CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:93453-8720
Mailing Address - Country:US
Mailing Address - Phone:805-438-4293
Mailing Address - Fax:
Practice Address - Street 1:3241 S HIGUERA ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-6924
Practice Address - Country:US
Practice Address - Phone:805-544-4460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF95011430207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine