Provider Demographics
NPI:1598892580
Name:BORNE, DEBORAH E (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:E
Last Name:BORNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 LECH WALESA
Mailing Address - Street 2:TOM WADDELL
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4506
Mailing Address - Country:US
Mailing Address - Phone:415-355-7540
Mailing Address - Fax:415-355-7401
Practice Address - Street 1:50 LECH WALESA
Practice Address - Street 2:TOM WADDELL
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4506
Practice Address - Country:US
Practice Address - Phone:415-355-7540
Practice Address - Fax:415-355-7401
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224785207Q00000X
CAA75224207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
965913OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER
H73771Medicare UPIN