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General NPI Number Information
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NPI Number | 1396146486
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Entity Type | Individual
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Provider Name | SVETLANA GRINBERG DO
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Gender | Female
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Dates
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Enumeration Date | 09/09/2014
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 704 LEBEC ROAD
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City | LEBEC
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State | CA
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Zip | 93243
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Country | US
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Telephone | 661-248-5250
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Fax | 661-248-5279
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Provider Business Mailing Address
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Address Line | PO BOX 278
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City | MADISONVILLE
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State | TN
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Zip | 37354-0278
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Country | US
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Telephone | 423-442-2622
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Fax | 423-442-5760
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 3527
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License Number State | TN
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