Healthcare Provider Details

I. General information

NPI: 1477674455
Provider Name (Legal Business Name): GRADY MAGURES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2717 EL CAMINO AVE
SACRAMENTO CA
95821-5903
US

IV. Provider business mailing address

2717 EL CAMINO AVE
SACRAMENTO CA
95821-5903
US

V. Phone/Fax

Practice location:
  • Phone: 916-486-2581
  • Fax: 916-486-2582
Mailing address:
  • Phone: 916-486-2581
  • Fax: 916-486-2582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA11
License Number StateCA

VIII. Authorized Official

Name: GRADY A MAGURES
Title or Position: PRESIDENT
Credential: HEARING AID DISPENSE
Phone: 916-486-2581