Active NPI
Karin Boresoff
- Specialist
- Lakewood, CA
National Provider Identifier
1497476600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- L9739
- Practice address
- 5509 South St
Lakewood, CA 90713-1301 - Phone
- (562) 538-6053
- NPI assigned
- Sep 6, 2022
- Last updated
- Sep 6, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | L9739 | CA | Primary |
Addresses
Primary practice location
5509 South St
Lakewood, CA 90713-1301
Mailing address
11518 Flossmoor Rd
Santa Fe SPGS, CA 90670-3104
Phone (562) 743-5031
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L9739 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662422400000",
"number": "1497476600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11518 FLOSSMOOR RD",
"city": "SANTA FE SPGS",
"state": "CA",
"postal_code": "906703104",
"telephone_number": "562-743-5031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5509 SOUTH ST",
"city": "LAKEWOOD",
"state": "CA",
"postal_code": "907131301",
"telephone_number": "562-538-6053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORESOFF",
"first_name": "KARIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-06",
"last_updated": "2022-09-06",
"certification_date": "2022-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "L9739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.