| Doctor Name: | DR. JERRY GRIGOROPOULOS |
| NPI Number: | 1326085671 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | A73614 |
| Business Practice Address: | 1524 Mchenry Ave Suite 100 Modesto, CA - 953504500 |
| Business Phone Number: | 2095716622 |
| Business Fax Number: | 2095272069 |
| Mailing Address: | 101 Park Ave, MODESTO |
| State: | CA |
| Postal Code: | 953540556 |
| Phone Number: | 2095716622 |
| Fax Number: | 2095272069 |
| NPI Enumeration Date: | 06/02/2006 |
| NPI Last Update Date: | 04/29/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | A73614 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |