Tatyana Borodulin (NPI# 1912940628, PAC ID# 9537252705) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1912940628 |
| PAC ID by PECOS | 9537252705 |
| Professional Enrollment ID | I20070904000351 |
| Full Name | Tatyana Borodulin |
| Organization Legal Name | TATYANA V. BORODULIN MD, INC |
| Address |
1600 W Campbell Ave Suite 202 Campbell CA 95008-1526 |
| Phone Number | 4083783300 |
| Gender | F |
| Graduation Year | 1988 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 6800832759 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050380 | GOOD SAMARITAN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1600 W Campbell Ave, Suite 202, Campbell, CA 95008-1526 | 4083783300 | TATYANA V. BORODULIN MD, INC |
| Organization Legal Name | TATYANA V. BORODULIN MD, INC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Ponedelnikov | Internal Medicine | Tatyana V. Borodulin Md, Inc | 1600 W Campbell Ave, Suite 202, Campbell, CA 95008-1526 |
| Street Address |
1600 W CAMPBELL AVE SUITE 202 |
| City | CAMPBELL |
| State | CA |
| Zip | 95008-1526 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Ponedelnikov | Internal Medicine | Tatyana V. Borodulin Md, Inc | 1600 W Campbell Ave, Suite 202, Campbell, CA 95008-1526 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melody L Lynd | Plastic and Reconstructive Surgery | 80 E Hamilton Ave, Campbell, CA 95008-0204 | |
| Jennifer Strangis | Physical Therapy | Deryke and Associates, Inc | 201 E Hamilton Ave, Campbell, CA 95008-0206 |
| Jared M Mason | Physical Therapy | Deryke and Associates, Inc | 201 E Hamilton Ave, Campbell, CA 95008-0206 |
| Sandra Deryke | Physical Therapy | Deryke and Associates, Inc | 201 E Hamilton Ave, Campbell, CA 95008-0206 |
| Allison Lorraine Keneally | Physical Therapy | Deryke and Associates, Inc | 201 E Hamilton Ave, Campbell, CA 95008-0206 |
| Sarah E Christiansen | Physical Therapy | Deryke and Associates, Inc | 201 E Hamilton Ave, Campbell, CA 95008-0206 |
| Michelle Regoli | Occupational Therapy | Deryke and Associates, Inc | 201 E Hamilton Ave, Campbell, CA 95008-0206 |
| Jennifer Jones | Physical Therapy | Deryke and Associates, Inc | 201 E Hamilton Ave, Campbell, CA 95008-0206 |
| Kanchan Anjaneya Thakar | Physical Therapy | Deryke and Associates, Inc | 201 E Hamilton Ave, Campbell, CA 95008-0206 |
| Albert Tailon Chang | Optometry | Peter W Ross Od and Larry K Wan Od Inc | 338 E Hamilton Ave, Campbell, CA 95008-0207 |
| Find all physicians in zip 95008 | |||
| City | CAMPBELL |
| Zip Code | 95008 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | CAMPBELL + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Tatyana Borodulin.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.