Organization Name: | JAMES L GRISEZ, MD |
NPI Number: | 1255459020 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DIANE MADELINE GRISEZ (ADMINISTRATOR) |
Mailing Address: | 200 Station Way Ste 200b Arroyo Grande |
State: | CA US |
Postal Code: | 934203348 |
Phone Number: | 8054891409 |
Fax Number: | 8954891290 |
NPI Enumeration Date: | 03/27/2007 |
NPI Last Update Date: | 03/05/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |