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General NPI Number Information
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NPI Number | 1356305254
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Entity Type | Individual
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Provider Name | IRMINA GRADUS-PIZLO M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 12/22/2022
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Provider Practice Location Address
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Address Line | 101 THE CITY DR S
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City | ORANGE
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State | CA
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Zip | 92868-3201
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Country | US
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Telephone | 714-880-7812
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Fax |
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Provider Business Mailing Address
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Address Line | 200 S MANCHESTER AVE STE 300
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City | ORANGE
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State | CA
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Zip | 92868-3219
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Country | US
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Telephone | 714-456-2986
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 01044711
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 01044711A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | C150958
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 01044711A
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License Number State | IN
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