Physician Compare National (NPI:1063571834)

HEALTHCARE PROVIDER: ADRIENNE ANN GRANT D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1063571834
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5597866764
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070718000764
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRANT
	Individual professional last name
Provider First Name	ADRIENNE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1997
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	OSTEOPATHIC MANIPULATIVE MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	OSTEOPATHIC MANIPULATIVE MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1400 COLORADO BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A
	Group Practice or individual's line 2 address
City	EAGLE ROCK
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	900412321
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y