Healthcare Provider Details

I. General information

NPI: 1740367085
Provider Name (Legal Business Name): ONLY GRACE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5535 CANCHA DE GOLF STE 101
RANCHO SANTA FE CA
92091-9504
US

IV. Provider business mailing address

1959 PALOMAR OAKS WAY STE 330
CARLSBAD CA
92011-1313
US

V. Phone/Fax

Practice location:
  • Phone: 858-759-6325
  • Fax: 858-759-6329
Mailing address:
  • Phone: 858-759-6325
  • Fax: 858-759-6329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARI CATHERINE MUSCIO
Title or Position: OWNER PRESIDENT
Credential:
Phone: 858-759-6325