Active NPI
Brock Allen Borah, DC
- Rehabilitation Chiropractor
- Glendale, CA
National Provider Identifier
1427147305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- DC 13461
- Practice address
- 1620 Victory Blvd
Glendale, CA 91201-2915 - Phone
- (818) 843-3333
- Fax
- (818) 396-1512
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | DC 13461 | CA | Primary |
Addresses
Primary practice location
1620 Victory Blvd
Glendale, CA 91201-2915
Mailing address
PO Box 3691
Burbank, CA 91508-3691
Phone (818) 843-3333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC 13461 | CA | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447027200000",
"number": "1427147305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3691",
"city": "BURBANK",
"state": "CA",
"postal_code": "915083691",
"telephone_number": "818-843-3333",
"fax_number": "818-396-1512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 VICTORY BLVD",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912012915",
"telephone_number": "818-843-3333",
"fax_number": "818-396-1512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORAH",
"first_name": "BROCK",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2015-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "CA",
"license": "DC 13461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.