Provider Demographics
NPI:1255379939
Name:GRAVORI, TOORAJ TODD (MD)
Entity type:Individual
Prefix:DR
First Name:TOORAJ
Middle Name:TODD
Last Name:GRAVORI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16311 VENTURA BLVD STE 1065
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4349
Mailing Address - Country:US
Mailing Address - Phone:818-390-9100
Mailing Address - Fax:818-390-9111
Practice Address - Street 1:16311 VENTURA BLVD STE 1065
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4349
Practice Address - Country:US
Practice Address - Phone:818-390-9100
Practice Address - Fax:818-390-9111
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA75506207XS0117X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine