Kaydee Bork, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

11515 El Camino Real
Suit 150
San Diego, CA 92130

Phone

(858) 720-1440

Fax

(858) 509-7738

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kaydee Oneill Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377820800000",
    "number": "1669579850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11515 EL CAMINO REAL",
            "address_2": "SUIT 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92130",
            "telephone_number": "858-720-1440",
            "fax_number": "858-509-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11515 EL CAMINO REAL",
            "address_2": "SUIT 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92130",
            "telephone_number": "858-720-1440",
            "fax_number": "858-509-7738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORK",
        "first_name": "KAYDEE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYDEE",
            "last_name": "ONEILL",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Boris Khamishon., Prof. Corp
• Boris Khamishonmd
• Blaire Borisoff, DO
• Victoria Aide Borja Meza
• Cheryl Borja, ATC
• Madeline Borkenhagen, LCSW
• John David Borman, M.D.
• Jill Bormann, PHD, RN
• Wayne Bormann, LVN
• Born to Blossom, LLC

• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; 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.