Provider Demographics
NPI:1265599708
Name:KIRKOROWICZ, GREGORY BOGDAN (MD)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:BOGDAN
Last Name:KIRKOROWICZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:#811
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618
Mailing Address - Country:US
Mailing Address - Phone:714-543-2554
Mailing Address - Fax:949-854-6310
Practice Address - Street 1:1401 N TUSTIN AVE
Practice Address - Street 2:#140
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705
Practice Address - Country:US
Practice Address - Phone:714-543-2554
Practice Address - Fax:714-835-1383
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA0254052251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology