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General NPI Number Information
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NPI Number | 1730405440
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Entity Type | Individual
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Provider Name | BORYS GVOZDYEV MD
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Gender | Male
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Dates
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Enumeration Date | 04/20/2010
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 9940 TALBERT AVE STE 202
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-5153
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Country | US
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Telephone | 949-988-0000
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Fax | 949-988-4000
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Provider Business Mailing Address
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Address Line | 17870 NEWHOPE ST STE 104-197
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-5439
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Country | US
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Telephone | 949-342-8892
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | A144225
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A144225
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 47717
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License Number State | KY
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