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General NPI Number Information
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NPI Number | 1932549623
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Entity Type | Individual
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Provider Name | JONATHAN SHARP GRIGSBY D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2013
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 7526 MONTEREY ST
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City | GILROY
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State | CA
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Zip | 95020-5826
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Country | US
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Telephone | 408-848-9400
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Fax | 408-848-9464
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Provider Business Mailing Address
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Address Line | 160 E VIRGINIA ST
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City | SAN JOSE
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State | CA
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Zip | 95112-5857
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Country | US
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Telephone | 408-579-6178
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A12866
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License Number State | CA
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