MEDICARE: SANDRA NUNEZ GRANGER RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	RN95248650	CA

General Provider Information

NPI Number	:	1174473763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA NUNEZ GRANGER RN

Provider Business Mailing Address
First Line	:	3451 E 12TH ST
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94601-3463
Country	:	US
Telephone Number	:	510-535-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	3451 E 12TH ST
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94601-3463
Country	:	US
Telephone Number	:	510-535-3500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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