Individual
DR. KOOROSH KOOROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8110 BIRMINGHAM WAY, SAN DIEGO, CA 92123-2758
(858) 966-4032
Mailing address
3020 CHILDRENS WAY, MC 5003, SAN DIEGO, CA 92123-4223
(858) 309-6300
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
002125
NY
2080P0206X
Pediatric Gastroenterology Physician
Primary
C138035
CA
2080P0206X
Pediatric Gastroenterology Physician
N7631
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02562449
—
NY
Enumeration date
07/05/2006
Last updated
08/31/2016
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