MEDICARE: MARCI L GREIM

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	235Z00000X	Speech-Language Pathologist	SP12391	CA

General Provider Information

NPI Number	:	1295057214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCI L GREIM

Provider Business Mailing Address
First Line	:	4327 N TALMADGE DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-2526
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4327 N TALMADGE DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-2526
Country	:	US
Telephone Number	:	858-232-4488
Fax Number	:

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

Provider Enumeration Date	:	02/17/2010
Last Update Date	:	02/17/2010

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Directions to “ MARCI L GREIM ” Practice Location

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