Obel Borrajero, | |
250 Prospect Pl, Coronado, CA 92118-1943 | |
(619) 522-3600 | |
Not Available |
Full Name | Obel Borrajero |
---|---|
Gender | Male |
Speciality | Nurse Practitioner |
Location | 250 Prospect Pl, Coronado, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1093280588 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 95010239 (California) | Primary |
Entity Name | Imperial Beach Community Clinic |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790718351 PECOS PAC ID: 6709867880 Enrollment ID: O20040525001394 |
Mailing Address | Practice Location Address |
---|---|
Obel Borrajero, 175 N Jackson Ave, Ste 110, San Jose, CA 95116-1909 Ph: (619) 788-3530 | Obel Borrajero, 250 Prospect Pl, Coronado, CA 92118-1943 Ph: (619) 522-3600 |
Rosalind Fenton, FNP-BC, GNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 230 Prospect Pl Ste 340b, Coronado, CA 92118 Phone: 619-522-4000 | |
Molly Devine, ENP-C, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 810 G Ave Apt 2, Coronado, CA 92118 Phone: 401-301-3643 | |
Charlie R Perez, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 158 C Ave, Coronado, CA 92118 Phone: 619-435-5400 | |
Lindsay Olson Mack, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 230 Prospect Pl Ste 340b, Coronado, CA 92118 Phone: 619-522-4000 Fax: 619-435-0150 | |
Christina Lam, FNP-BC Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 158 C Ave, Coronado, CA 92118 Phone: 619-435-5400 Fax: 619-435-5401 | |
Mrs. Natasha Hicks Lubrano, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 230 Prospect Pl, 340b, Coronado, CA 92118 Phone: 619-522-4000 Fax: 619-435-0150 |