Active NPI
Boris Zhalkovsky Medical Corporation
- Psychiatry Physician
- San Carlos, CA
National Provider Identifier
1710049655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- BORIS ZHALKOVSKY MEDICAL CORPORATION
- Practice address
- 809 Laurel St Unit 6912
San Carlos, CA 94070-7766 - Phone
- (650) 219-3600
- NPI assigned
- Dec 15, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Boris Zhalkovsky, MD
- Title
- The President
- Phone
- (650) 219-3600
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary |
Addresses
Primary practice location
809 Laurel St Unit 6912
San Carlos, CA 94070-7766
Mailing address
809 Laurel St Unit 6912
San Carlos, CA 94070-7766
Phone (650) 219-3600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A563750 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040224001346 | CA | Part B Supplier - Clinic/Group Practice | 9335042100 |
Receives reassigned benefits from 1 practitioner Practice locations: San Leandro, CA; San Mateo, CA; Sacramento, CA; Castro Valley, CA |
National Provider Directory
National Provider DirectoryLocations
3430 Balmoral Dr
Ste 8
Sacramento, CA 95821
Phone (650) 219-3600
809 Laurel St
Unit 6912
San Carlos, CA 94070
Phone (650) 219-3600
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Neurology Physician
- West Sacramento, CA
- NPI 1477537413
-
- Clinical Psychologist
- Castro Valley, CA
- NPI 1942363122
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1710049655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "809 LAUREL ST UNIT 6912",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940707766",
"telephone_number": "650-219-3600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 LAUREL ST UNIT 6912",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940707766",
"telephone_number": "650-219-3600"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BORIS ZHALKOVSKY MEDICAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-15",
"last_updated": "2025-09-11",
"certification_date": "2025-09-11",
"status": "A",
"authorized_official_last_name": "ZHALKOVSKY",
"authorized_official_first_name": "BORIS",
"authorized_official_title_or_position": "THE PRESIDENT",
"authorized_official_telephone_number": "650-219-3600",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A563750",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Carlos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.