Lawrence N Borelli, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

G25506 Issued in CA

Legal business name

LAWRENCE N BORELLI, M.D.

Practice address

1220 La Venta Dr
Suite 201
Westlake Village, CA 91361-3703

Phone

(805) 381-1953

Fax

(805) 381-1079

NPI assigned

Jul 30, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Nichelle Christine Vasquez

Title

Office Manager

Phone

(805) 381-1953

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• L.N.BORELLI M.D.,INC Doing business as

Locations

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

{
    "created_epoch": "1280448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308787200000",
    "number": "1487968509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 LA VENTA DR",
            "address_2": "SUITE 201",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913613703",
            "telephone_number": "805-381-1953",
            "fax_number": "805-381-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 LA VENTA DR",
            "address_2": "SUITE 201",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913613703",
            "telephone_number": "805-381-1953",
            "fax_number": "805-381-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE N BORELLI, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-30",
        "last_updated": "2011-06-23",
        "status": "A",
        "authorized_official_last_name": "VASQUEZ",
        "authorized_official_first_name": "NICHELLE",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "805-381-1953",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G25506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "G25506",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN #",
            "identifier": "G25506B",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "A42694",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "L.N.BORELLI M.D.,INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.