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General NPI Number Information
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NPI Number | 1982910741
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Entity Type | Organization
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Legal Business Name | JOHN A GRIMALDI DO INC
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Dates
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Enumeration Date | 08/31/2010
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 450 4TH AVE SUTIE 312
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City | CHULA VISTA
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State | CA
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Zip | 91910-4426
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Country | US
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Telephone | 619-420-0201
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Fax |
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Provider Business Mailing Address
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Address Line | 450 4TH AVE SUTIE 312
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City | CHULA VISTA
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State | CA
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Zip | 91910-4426
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Country | US
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Telephone | 619-420-0201
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN A GRIMALDI
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Credential | DO
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Telephone | 619-420-0201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 20A11355
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License Number State | CA
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