Active NPI
Sybil Bordenave, PA-C
- Medical Physician Assistant
- Paramount, CA
National Provider Identifier
1104361005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA14485
- Practice address
- 15745 Paramount Blvd
Paramount, CA 90723-4332 - Phone
- (562) 808-2273
- NPI assigned
- Dec 30, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA14485 | CA | Primary |
Addresses
Primary practice location
15745 Paramount Blvd
Paramount, CA 90723-4332
Mailing address
18375 Ventura Blvd # 630
Tarzana, CA 91356-4218
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA14485 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eugene Allen MD Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Paramount, CA
- NPI 1225182801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483056000000",
"number": "1104361005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18375 VENTURA BLVD # 630",
"city": "TARZANA",
"state": "CA",
"postal_code": "913564218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15745 PARAMOUNT BLVD",
"city": "PARAMOUNT",
"state": "CA",
"postal_code": "907234332",
"telephone_number": "562-808-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORDENAVE",
"first_name": "SYBIL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-30",
"last_updated": "2016-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA14485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paramount, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.