MEDICARE: WILLIAM GRANT MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1063351534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM GRANT MD INC

Provider Business Mailing Address
First Line	:	PO BOX 34120
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89533-4120
Country	:	US
Telephone Number	:	877-747-5050
Fax Number	:	775-747-5005

Provider Business Practice Location Address
First Line	:	15611 POMERADO RD STE 220
Second Line	:
City	:	POWAY
State	:	CA
Zip	:	92064-2437
Country	:	US
Telephone Number	:	858-521-0031
Fax Number	:	858-521-0921

Authorized Official
Title or Position	:	OWNER
Name	:	WILLIAM GRANT
Credential	:	MD
Telephone Number	:	858-521-0031

Provider Enumeration Date	:	03/27/2026
Last Update Date	:	03/27/2026

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