Healthcare Provider Details

I. General information

NPI: 1104196146
Provider Name (Legal Business Name): CATHERINE R GRINSTEAD DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2012
Last Update Date: 01/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4990 MANZANITA AVE SACRAMENTO ANIMAL MEDICAL GROUP
CARMICHAEL CA
95608
US

IV. Provider business mailing address

4990 MANZANITA AVE SACRAMENTO ANIMAL MEDICAL GROUP
CARMICHAEL CA
95608
US

V. Phone/Fax

Practice location:
  • Phone: 916-331-7430
  • Fax: 916-331-5883
Mailing address:
  • Phone: 916-331-7430
  • Fax: 916-331-5883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number12647
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: