| Doctor Name: | SALLYANN P GRISOLIA |
| NPI Number: | 1235348160 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RT |
| License Number: | RHT 82896 |
| Business Practice Address: | 18945 Fm 2252 Ste 115 Garden Ridge, TX - 782662797 |
| Business Phone Number: | 2106510027 |
| Business Fax Number: | |
| Mailing Address: | 7454 Eads Ave, LA JOLLA |
| State: | CA |
| Postal Code: | 920375036 |
| Phone Number: | 8585510285 |
| Fax Number: | |
| NPI Enumeration Date: | 05/21/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471N0900X |
| License Number: | RHT 82896 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Nuclear Medicine Technology |
| Taxonomy Definition: | |