Provider Demographics
NPI:1558095091
Name:GORECKA, MAGDALENA (PT)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:
Last Name:GORECKA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22750 HAWTHORNE BLVD STE 227
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3670
Mailing Address - Country:US
Mailing Address - Phone:323-849-4828
Mailing Address - Fax:
Practice Address - Street 1:22750 HAWTHORNE BLVD STE 227
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3670
Practice Address - Country:US
Practice Address - Phone:323-849-4828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36449225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist