Richard A Bordow, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

G31546 Issued in CA

Practice address

2101 Vale Rd Ste 300
San Pablo, CA 94806-3846

Phone

(510) 233-3788

Fax

(510) 233-3390

NPI assigned

Aug 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283731200000",
    "number": "1477563583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 VALE RD STE 300",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063846",
            "telephone_number": "510-233-3788",
            "fax_number": "510-233-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 VALE RD STE 300",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063846",
            "telephone_number": "510-233-3788",
            "fax_number": "510-233-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDOW",
        "first_name": "RICHARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2010-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G31546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G315460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Allison M. Bowne, M.S. MFTI
• Imani Samaria Bradford
• Maureen Lucille Brannon
• Joshua Braslow

• Pulmonary Disease Physician in San Pablo, CA
• Providers in San Pablo, CA by specialty
• Pulmonary Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2010; 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.