Provider Demographics
NPI:1932314259
Name:GRIGORIOU, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:GRIGORIOU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1548 VALENCIA
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3278
Mailing Address - Country:US
Mailing Address - Phone:551-579-2159
Mailing Address - Fax:714-965-0682
Practice Address - Street 1:21501 BROOKHURST ST
Practice Address - Street 2:SUITE E
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-8080
Practice Address - Country:US
Practice Address - Phone:714-963-7712
Practice Address - Fax:714-965-0682
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00611600111N00000X
CA31675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ071033Medicare ID - Type Unspecified
NJU95843Medicare UPIN