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NPI Code Detail

MEDICARE: MR. RYAN JOSEPH GRUMICH

MEDICARE: MR. RYAN JOSEPH GRUMICH
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
1225400000XRehabilitation PractitionerCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13456OTHERCAMEDICAL

General Provider Information

NPI Number : 1285860718
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RYAN JOSEPH GRUMICH
Provider Business Mailing Address
First Line : 2170 KAWANA TER
Second Line :
City : SANTA ROSA
State : CA
Zip : 95404-6331
Country : US
Telephone Number : 707-799-2439
Fax Number :
Provider Business Practice Location Address
First Line : 634 PRESSLEY ST
Second Line :
City : SANTA ROSA
State : CA
Zip : 95404-5526
Country : US
Telephone Number : 707-573-6955
Fax Number : 707-543-8176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2009
Last Update Date : 12/09/2025

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Directions to “ MR. RYAN JOSEPH GRUMICH ” Practice Location

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