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General NPI Number Information
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NPI Number | 1437824836
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Entity Type | Individual
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Provider Name | CEDAR MARIN GRICE NP
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Gender | Male
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Dates
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Enumeration Date | 08/09/2021
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Last Update Date | 08/09/2021
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Provider Practice Location Address
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Address Line | 7070 HOLLISTER AVE STE 103
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City | GOLETA
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State | CA
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Zip | 93117-2895
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Country | US
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Telephone | 805-324-9270
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Fax |
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Provider Business Mailing Address
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Address Line | 548 WALNUT LN
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City | SANTA BARBARA
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State | CA
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Zip | 93111-2633
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Country | US
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Telephone | 805-705-0642
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP95016903
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License Number State | CA
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