Irina Borodulin-Smik, PAC, DC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA22970 Issued in CA

Practice address

1674 N Shoreline Blvd
Mountain View, CA 94043-1374

Phone

(650) 386-0323

NPI assigned

Jul 20, 2006

Last updated

Jun 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Smik Chiropractic, Inc.

  • Chiropractor
  • San Jose, CA
  • NPI 1982709762
  NPD (past) Authorized official
• Bass Medical Group

  • Specialist
  • Walnut Creek, CA
  • NPI 1154401941
  NPD (past)
• Carbon Health Primary Care of California PC

  • Multi-Specialty Clinic/Center
  • Berkeley, CA
  • NPI 1972057990
  NPD (past)
• Ebadat Chiropractic Inc.

  • Chiropractor
  • San Jose, CA
  • NPI 1003006404
  NPD (past)
• Intrahealth Physical Therapy

  • Physical Therapist
  • Cupertino, CA
  • NPI 1891739314
  NPD (past)
• One Medical Group, Inc.

  dba One Medical

  • Family Medicine Physician
  • Sunnyvale, CA
  • NPI 1538681218
  NPD (past)
• Petra Eggert

  dba IntraHealth

  • Chiropractor
  • Cupertino, CA
  • NPI 1932366085
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718496000000",
    "number": "1629098116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1674 N SHORELINE BLVD",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940431374",
            "telephone_number": "408-810-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1674 N SHORELINE BLVD",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940431374",
            "telephone_number": "650-386-0323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "803 Eleventh Ave",
            "address_purpose": "LOCATION",
            "city": "Sunnyvale",
            "state": "CA",
            "postal_code": "940894731",
            "country_code": "US",
            "telephone_number": "408-228-1025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Old San Francisco Rd",
            "address_purpose": "LOCATION",
            "city": "Sunnyvale",
            "state": "CA",
            "postal_code": "940866386",
            "country_code": "US",
            "telephone_number": "408-730-4360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORODULIN-SMIK",
        "first_name": "IRINA",
        "name_prefix": "Dr.",
        "credential": "PAC, DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-06-16",
        "certification_date": "2024-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22970",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 27390",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DC0273900",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ64417Z-30",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kerry Barnholt Bonar, P.T.
• Jocelynn Grace Bonilla
• Chris Bonsall Sr.
• Bonsall's Shoes Inc (Foot Solutions)
• Allana Booth, M.S.
• Jesus Luigi Borrillo, MD
• Cristina Marie Bostanian-Quezada, LCSW
• Edward Bough, M.D.
• Maximillian Bourdillon
• Joshua Bourekas

• Physician Assistant in Mountain View, CA
• Providers in Mountain View, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2024; 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.