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NPI Code Detail

MEDICARE: DR. BROCK ALLEN BORAH DC

MEDICARE: DR. BROCK ALLEN BORAH DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NR0400XRehabilitation ChiropractorDC 13461CA

General Provider Information

NPI Number : 1427147305
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BROCK ALLEN BORAH DC
Provider Business Mailing Address
First Line : PO BOX 3691
Second Line :
City : BURBANK
State : CA
Zip : 91508-3691
Country : US
Telephone Number : 818-843-3333
Fax Number : 818-396-1512
Provider Business Practice Location Address
First Line : 1620 VICTORY BLVD
Second Line :
City : GLENDALE
State : CA
Zip : 91201-2915
Country : US
Telephone Number : 818-843-3333
Fax Number : 818-396-1512
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 11/09/2015

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Directions to “ DR. BROCK ALLEN BORAH DC” Practice Location

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