Individual provider Active NPI

Deborah Sue Borg, CNP

  • Nurse Practitioner
  • West Hollywood, CA
National Provider Identifier
1528428273
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95010448 Issued in CA
Practice address
8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone
(310) 423-5000
NPI assigned
Feb 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA.18846-NP OH
Nurse Practitioner 363L00000X 95010448 CA Primary

Addresses

Primary practice location

8700 Beverly Blvd
West Hollywood, CA 90048-1804

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513
Phone (310) 423-5000

Other names 1

  • Deborah Sue Macuich Former name

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)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95010448CAMDNurse Practitioner
COA.18846-NPOHMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1528428273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513",
            "telephone_number": "310-423-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "310-423-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORG",
        "first_name": "DEBORAH",
        "middle_name": "SUE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.18846-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95010448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "MACUICH",
            "middle_name": "SUE",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.