# BORWORN RATTIDHAM,MD.,P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689865776
- **Authorized official:** DR. BORWORN RATTIDHAM M.D. (PRESIDENT)
- **Authorized official phone:** (951) 943-8110

## Contact information

- **Practice address:** 126 AVOCADO AVE STE 102, PERRIS, CA 92571-2605
- **Practice address phone:** (951) 943-8110
- **Mailing address:** 126 AVOCADO AVE STE 102, PERRIS, CA 92571-2605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | A25955 | CA | Yes |

## Other

- **Enumeration date:** 08/05/2007
- **Last updated:** 08/05/2007