Provider Demographics
NPI:1134258148
Name:GERBATSCH-BORNEMISZA, ILDIKO CHRISTINE (MD)
Entity type:Individual
Prefix:MS
First Name:ILDIKO
Middle Name:CHRISTINE
Last Name:GERBATSCH-BORNEMISZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ILDIKO
Other - Middle Name:CHRISTINE
Other - Last Name:GERBATSCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3490 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-1664
Mailing Address - Country:US
Mailing Address - Phone:619-423-5616
Mailing Address - Fax:619-423-8564
Practice Address - Street 1:3490 PALM AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-1664
Practice Address - Country:US
Practice Address - Phone:619-423-5616
Practice Address - Fax:619-423-8564
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63645207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine