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General NPI Number Information
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NPI Number | 1831347392
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Entity Type | Organization
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Legal Business Name | GARY GRINBERG, M.D., INC
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 09/09/2011
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Provider Practice Location Address
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Address Line | 800 HOWE AVE SUITE 300
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City | SACRAMENTO
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State | CA
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Zip | 95825-3911
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Country | US
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Telephone | 916-568-5551
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Fax | 916-568-5575
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Provider Business Mailing Address
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Address Line | 800 HOWE AVE SUITE 300
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City | SACRAMENTO
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State | CA
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Zip | 95825-3911
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Country | US
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Telephone | 916-568-5551
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Fax | 916-568-5575
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY GRINBERG
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Credential | M.D.
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Telephone | 916-568-5551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A100593
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License Number State | CA
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