Healthcare Provider Details

I. General information

NPI: 1730274309
Provider Name (Legal Business Name): NEIL GRANADER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 02/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

REGIONAL MEDICAL CENTER OF SAN JOSE 225 N. JACKSON AVENUE
SAN JOSE CA
95116
US

IV. Provider business mailing address

P.O.BOX 59282
SAN JOSE CA
95159
US

V. Phone/Fax

Practice location:
  • Phone: 408-297-0227
  • Fax: 408-297-0237
Mailing address:
  • Phone: 408-297-0227
  • Fax: 408-297-0237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberA44725
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: