| Boris Zhalkovsky Medical Corporation | |
|
20081 Lake Chabot Road Boris Zhalkovsky Medical Corporation Castro Valley CA 94546-5303 | |
| (510) 690-1155 | |
| (510) 690-1344 |
| Full Name | Boris Zhalkovsky Medical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 20081 Lake Chabot Road, Castro Valley, California |
| Authorized Official Name and Position | Boris Zhalkovsky (THE PRESIDENT) |
| Authorized Official Contact | 5106901155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boris Zhalkovsky Medical Corporation 20081 Lake Chabot Road Boris Zhalkovsky Medical Corporation Castro Valley CA 94546-5303 Ph: (510) 690-1155 | Boris Zhalkovsky Medical Corporation 20081 Lake Chabot Road Boris Zhalkovsky Medical Corporation Castro Valley CA 94546-5303 Ph: (510) 690-1155 |
| NPI Number | 1710049655 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9335042100 |
|---|---|
| Medicare Enrollment ID | O20040224001346 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710049655 | NPI | - | NPPES |
| 00A563750 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Boris Zhalkovsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518146489 PECOS PAC ID: 7113820986 Enrollment ID: I20040129000389 |
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