Healthcare Provider Details

I. General information

NPI: 1558151274
Provider Name (Legal Business Name): ERIN GREUEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2025
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4044 5TH AVE
SAN DIEGO CA
92103-2106
US

IV. Provider business mailing address

13853 BARRYMORE ST
SAN DIEGO CA
92129-3115
US

V. Phone/Fax

Practice location:
  • Phone: 619-849-4469
  • Fax: 619-849-1547
Mailing address:
  • Phone: 218-779-6622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number95225986
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: