Organization Active NPI

Borys Gvozdyev MD a Professional Medical Corporation

  • Orthopaedic Surgery of the Spine Physician
  • Fountain Valley, CA
National Provider Identifier
1144888348
Registry record updated Aug 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
BORYS GVOZDYEV MD A PROFESSIONAL MEDICAL CORPORATION
Practice address
18111 Brookhurst St Ste 2600
Fountain Valley, CA 92708-6728
Phone
(949) 988-0000
Fax
(949) 988-4000
NPI assigned
Jun 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Borys Gvozdyev, MDNPI 1730405440
Title
President
Phone
(949) 988-0000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0117X Primary

Addresses

Primary practice location

18111 Brookhurst St Ste 2600
Fountain Valley, CA 92708-6728

Mailing address

17870 Newhope St Ste 104-197
Fountain Valley, CA 92708-5439
Phone (499) 342-8892

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20191106003181 CA Part B Supplier - Clinic/Group Practice 2961834262 Receives reassigned benefits from 1 practitioner
Practice locations: Fountain Valley, CA; Lakewood, CA; San Juan Capistrano, CA
O20200818000132 CA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 2961834262 Practice locations: Fountain Valley, CA

National Provider Directory

National Provider Directory

Locations

18035 Brookhurst St
#1200
Fountain Valley, CA 92708
Phone (714) 963-7240

17870 Newhope St
Ste 104197
Fountain Valley, CA 92708
Phone (949) 342-8892

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787443200000",
    "number": "1144888348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17870 NEWHOPE ST STE 104-197",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085439",
            "telephone_number": "499-342-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST STE 2600",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728",
            "telephone_number": "949-988-0000",
            "fax_number": "949-988-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORYS GVOZDYEV MD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-03",
        "last_updated": "2026-08-23",
        "certification_date": "2026-08-23",
        "status": "A",
        "authorized_official_last_name": "GVOZDYEV",
        "authorized_official_first_name": "BORYS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-988-0000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.