Shariar Borbor, M.D.
Individual provider Active NPI Family Medicine Physician · Azusa, CA
NPI 1477868933 · NPPES record last updated Aug 11, 2022
Key facts
- NPI
- 1477868933
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A123079 (CA)
- Practice address
- 521 N Azusa Ave
Azusa, CA 91702-2936 - Phone
- (626) 334-4061
- Fax
- (626) 334-6828
- NPI assigned
- Aug 9, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
521 N Azusa Ave
Azusa, CA 91702-2936
Phone (626) 334-4061
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140211001413 | CA | Practitioner - Family Practice | 4284863499 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A123079 | CA | MD | Family Medicine Physician |
Practice roles (1 of 2)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pueblo Medical Associates Inc. | Current |
Accepting new patients |
Locations
521 N Azusa Ave
Azusa, CA 91702
Phone (626) 334-4061
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A123079 | CA | Yes |
Addresses
Primary practice location
521 N Azusa Ave
Azusa, CA 91702-2936
Mailing address
1014 Broadway # 617
Santa Monica, CA 90401-2808
Phone (626) 334-4061
Other providers in Azusa, CA
- Rajiv H Bhuva
- Bina a Kamdar MD, Inc.
- Nicole Diane Bliss
- Viviana Boiso
- Stephanie Boles
- Cecilia Borja
- Nicole Brandt
- Brianne Luu, DMD, Inc.
- Garrett Rand Brooks
- Michelle Evette Brown-Black
All providers in Azusa, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.