Individual
KESARA BORIRAKCHANYAVAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13652 CANTARA ST, PANORAMA CITY, CA 91402-5423
(818) 375-3030
Mailing address
4285 FARMDALE AVE, STUDIO CITY, CA 91604-2734
(415) 377-0999
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A76396
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A763960
—
CA
Enumeration date
11/01/2006
Last updated
11/29/2021
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