Provider Demographics
NPI:1730963224
Name:BORJA, JUSTIN NAPUTI (IDHS)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:NAPUTI
Last Name:BORJA
Suffix:
Gender:M
Credentials:IDHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 CHANDIHA STREET
Mailing Address - Street 2:
Mailing Address - City:DEDEDO
Mailing Address - State:GU
Mailing Address - Zip Code:96929
Mailing Address - Country:US
Mailing Address - Phone:931-338-6737
Mailing Address - Fax:
Practice Address - Street 1:VICTOR WHARF PIER 3
Practice Address - Street 2:
Practice Address - City:SANTA RITA
Practice Address - State:GU
Practice Address - Zip Code:96915
Practice Address - Country:US
Practice Address - Phone:931-338-6737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman