Provider Demographics
NPI:1548807811
Name:BORCEGUIN, PABLO LUIS JR (DPT)
Entity type:Individual
Prefix:DR
First Name:PABLO
Middle Name:LUIS
Last Name:BORCEGUIN
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:DR
Other - First Name:PABLO
Other - Middle Name:
Other - Last Name:BORCEGUIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:765 N FAIR OAKS AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-3133
Mailing Address - Country:US
Mailing Address - Phone:408-394-3089
Mailing Address - Fax:
Practice Address - Street 1:1886 W SAN CARLOS ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1913
Practice Address - Country:US
Practice Address - Phone:408-394-3089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA297768225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist