Provider Demographics
NPI:1699351791
Name:BORDEN, LAURA BINKOWSKI (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BINKOWSKI
Last Name:BORDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:CAROLYN
Other - Last Name:BINKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:505 S MAIN ST STE 525
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4553
Mailing Address - Country:US
Mailing Address - Phone:714-456-5631
Mailing Address - Fax:
Practice Address - Street 1:505 S MAIN ST STE 525
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4553
Practice Address - Country:US
Practice Address - Phone:714-456-5631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-20
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program