Organization
LAWRENCE N BORELLI, M.D.
Active
Other names
L.N.BORELLI M.D.,INC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICHELLE CHRISTINE VASQUEZ (OFFICE MANAGER)
(805) 381-1953
Entity
Organization
Contact information
Practice address
1220 LA VENTA DR, SUITE 201, WESTLAKE VILLAGE, CA 91361-3703
(805) 381-1953
(805) 381-1079
Mailing address
1220 LA VENTA DR, SUITE 201, WESTLAKE VILLAGE, CA 91361-3703
(805) 381-1953
(805) 381-1079
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G25506
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A42694
UPIN
CA
01
—
G25506
STATE LICENSE
CA
01
—
G25506B
MEDICARE PTAN #
CA
Enumeration date
07/30/2010
Last updated
06/23/2011
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