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General NPI Number Information
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NPI Number | 1043011711
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Entity Type | Organization
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Legal Business Name | GREAS MEDICAL CORPORATION
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 10898 BRYN MAWR AVE
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City | LOMA LINDA
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State | CA
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Zip | 92354-4201
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Country | US
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Telephone | 818-406-6439
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Fax |
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Provider Business Mailing Address
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Address Line | 10898 BRYN MAWR AVE
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City | LOMA LINDA
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State | CA
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Zip | 92354-4201
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MICHAEL GREAS
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Credential | MD
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Telephone | 818-406-6439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number |
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License Number State |
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