Provider Demographics
NPI:1750317251
Name:BOROK, ZEA (MD)
Entity Type:Individual
Prefix:DR
First Name:ZEA
Middle Name:
Last Name:BOROK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 232410
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-2410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9000
Practice Address - Country:US
Practice Address - Phone:800-926-8273
Practice Address - Fax:888-539-8781
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA47911207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW11675OtherGROUP MEDICARE PIN
CAW18762OtherGROUP MEDICARE
CA00A47910Medicaid
CA1902846306OtherGROUP NPI
CAGR0100430OtherGROUP MEDICAL
00A479110197OtherCAL OPTIMA
CA1356390009OtherGROUP NPI
CAGR0016910OtherGROUP MEDICAID PIN
CA00A479110OtherBLUE SHIELD
CA110239195OtherRAILROAD MEDICARE
CACE1617OtherGROUP RAILROAD MEDICARE
CAW18762OtherGROUP MEDICARE
00A479110197OtherCAL OPTIMA