Provider Demographics
NPI:1184098683
Name:MCGORRAY, LAURA (PT, DPT, CEIM)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MCGORRAY
Suffix:
Gender:
Credentials:PT, DPT, CEIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8755 AERO DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1750
Mailing Address - Country:US
Mailing Address - Phone:619-578-2232
Mailing Address - Fax:619-578-2231
Practice Address - Street 1:8755 AERO DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1776
Practice Address - Country:US
Practice Address - Phone:619-578-2232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-20
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0391651225100000X
CA294340225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist