Borworn Rattidham,MD.,P.C.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

A25955 Issued in CA

Legal business name

BORWORN RATTIDHAM,MD.,P.C.

Practice address

126 Avocado Ave Ste 102
Perris, CA 92571-2605

Phone

(951) 943-8110

NPI assigned

Aug 5, 2007

Last updated

Aug 5, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Borworn Rattidham, M.D.

Title

President

Phone

(951) 943-8110

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186272000000",
    "number": "1689865776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 AVOCADO AVE STE 102",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925712605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 AVOCADO AVE STE 102",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925712605",
            "telephone_number": "951-943-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORWORN RATTIDHAM,MD.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A",
        "authorized_official_last_name": "RATTIDHAM",
        "authorized_official_first_name": "BORWORN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-943-8110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A25955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward S Bielecki
• Stasha Leigh Blackwell, LVN
• Citlally Margarita Blas Bonilla
• BLR Doula Services LLC
• Rachel Guillermina Borroel, APCC
• Annette Botello-Prieto
• Michael Bourdaa, PHARMD
• Marva Margaret Bourne, DMFT
• Dorotea Bowman
• Breanna Mone Brazier, DOULA/ CLE

• Medical Specialty Clinic/Center in Perris, CA
• Providers in Perris, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; 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.