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General NPI Number Information
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NPI Number | 1255459020
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Entity Type | Organization
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Legal Business Name | JAMES L GRISEZ, MD
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 03/05/2009
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Provider Practice Location Address
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Address Line | 200 STATION WAY STE 200B
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3348
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Country | US
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Telephone | 805-489-1409
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Fax | 895-489-1290
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Provider Business Mailing Address
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Address Line | 200 STATION WAY STE 200B
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3348
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Country | US
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Telephone | 805-489-1409
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Fax | 895-489-1290
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. DIANE MADELINE GRISEZ
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Credential | PHD
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Telephone | 805-489-1409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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