Deborshi Roy MD Inc

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

C54320 Issued in CA

Legal business name

DEBORSHI ROY MD INC

Practice address

8906 San Bernardino Rd
Suite104
Rancho Cucamonga, CA 91730-8805

Phone

(909) 466-0847

Fax

(909) 466-0867

NPI assigned

Jun 13, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Kimberly Diane Swanson

Title

Office Manager

Phone

(951) 738-8217

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307923200000",
    "number": "1497040919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77365",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928770112",
            "telephone_number": "951-738-8217",
            "fax_number": "951-738-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8906 SAN BERNARDINO RD",
            "address_2": "SUITE104",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917308805",
            "telephone_number": "909-466-0847",
            "fax_number": "909-466-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORSHI ROY MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-13",
        "last_updated": "2011-06-13",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "951-738-8217",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CA",
            "license": "C54320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology/Facial Plastic Surgery Physician in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Otolaryngology/Facial Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.