Provider Demographics
NPI:1669461919
Name:BORROMEO, SALVADOR GARCIA III (MD)
Entity Type:Individual
Prefix:DR
First Name:SALVADOR
Middle Name:GARCIA
Last Name:BORROMEO
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:801 S RANCHO DR STE A2
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3870
Mailing Address - Country:US
Mailing Address - Phone:702-483-3630
Mailing Address - Fax:800-579-9591
Practice Address - Street 1:801 S RANCHO DR STE A2
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3870
Practice Address - Country:US
Practice Address - Phone:702-483-3630
Practice Address - Fax:800-579-9591
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV8770174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVF68427Medicare UPIN
NV31302Medicare ID - Type Unspecified
NV2018123Medicaid