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General NPI Number Information
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NPI Number | 1912033341
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Entity Type | Individual
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Provider Name | RACHEL D GRINA PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4060 4TH AVE SUITE 610
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City | SAN DIEGO
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State | CA
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Zip | 92103
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Country | US
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Telephone | 619-497-2430
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Fax | 619-299-1723
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Provider Business Mailing Address
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Address Line | 3556 CAMINITO CARMEL LANDING
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City | SAN DIEGO
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State | CA
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Zip | 92130
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Country | US
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Telephone | 858-481-9163
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | PA12612
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License Number State | CA
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