| Geoffrey Paul Bork, LCSW | |
|
11th Street, Building 16105, Camp Pendleton, CA 92005-9200 | |
| (760) 725-5538 | |
| Not Available |
| Full Name | Geoffrey Paul Bork |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 11th Street, Camp Pendleton, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720677859 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 87459 (California) | Primary |
| Entity Name | Grow Healthcare Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154994846 PECOS PAC ID: 1850774746 Enrollment ID: O20220809004080 |
| Mailing Address | Practice Location Address |
|---|---|
| Geoffrey Paul Bork, LCSW 30419 Terrain St, Murrieta, CA 92563-1822 Ph: (619) 884-2061 | Geoffrey Paul Bork, LCSW 11th Street, Building 16105, Camp Pendleton, CA 92005-9200 Ph: (760) 725-5538 |
Mr. Gregory George Barisich, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Bldg H-100 Santa Margarita Road, Naval Hospital, Camp Pendleton (n68094), Camp Pendleton, CA 92055 Phone: 760-725-0025 | |
Miss Dorothea Elizabeth Ware, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: H200t Santa Margarita Rd Building 2738t, Camp Pendleton, CA 92057 Phone: 760-725-0063 | |
Valery Krupnik, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 200 Mercy Circle, Camp Pendleton, CA 92055 Phone: 760-719-3312 | |
Lisa C Whitney, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 200 Mercy Circle, Camp Pendleton, CA 92055 Phone: 760-719-3533 | |
Ms. Ingrid H Weibust, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: Building 130193t A Street, Box 55020, Camp Pendleton, CA 92055 Phone: 760-725-8301 | |
Mary Broccoli, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Naval Hospital, Camp Pendleton, Attention: Code 094, Camp Pendleton, CA 92055 Phone: 760-725-1555 Fax: 760-725-1350 | |
Susan Marie Gallardo, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2016 San Jacinto Road, Camp Pendleton, CA 92055 Phone: 760-719-4203 |