Individual
DR. BORNA MANSOURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
800 NE 10TH ST STE 2300, OKLAHOMA CITY, OK 73104-5418
(513) 862-3306
Mailing address
800 NE 10TH ST STE 2300, OKLAHOMA CITY, OK 73104-5418
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
43745
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2020
Last updated
06/28/2024
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