Individual provider Active NPI

Julio Jacinto Bordas, M.D.

  • Family Medicine Physician
  • Downey, CA
National Provider Identifier
1295834927
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G55479 Issued in CA
Practice address
12739 Lakewood Blvd
Downey, CA 90242-4521
Phone
(805) 881-3803
Fax
(866) 268-5736
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G55479 CA Primary

Addresses

Primary practice location

12739 Lakewood Blvd
Downey, CA 90242-4521

Mailing address

12739 Lakewood Blvd
Downey, CA 90242-4521
Phone (805) 881-3803

Other identifiers 1

IdentifierTypeStateIssuer
00G554790MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G55479CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Medical Group of California, Inc Family Medicine PastSince Sep 30, 2012 Accepting new patients
Divine Hospice Services, Inc. Past Accepting new patients
Osf Medical Group of California, Inc Family Medicine Past Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients
Keith Mark Gross MD Inc Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1295834927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12739 LAKEWOOD BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902424521",
            "telephone_number": "805-881-3803",
            "fax_number": "866-268-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12739 LAKEWOOD BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902424521",
            "telephone_number": "805-881-3803",
            "fax_number": "866-268-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDAS",
        "first_name": "JULIO",
        "middle_name": "JACINTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G55479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G554790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.