Healthcare Provider Details

I. General information

NPI: 1265652978
Provider Name (Legal Business Name): GRACE HUNTER, D.O., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 QUAIL RDG
IRVINE CA
92603-4228
US

IV. Provider business mailing address

PO BOX 51473
IRVINE CA
92619-1473
US

V. Phone/Fax

Practice location:
  • Phone: 949-837-9945
  • Fax: 949-305-3380
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. GRACE HUNTER
Title or Position: PRESIDENT
Credential: D.O.
Phone: 949-837-9945