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NPI Code Detail

MEDICARE: CAROLYN GRIBIK

MEDICARE: CAROLYN GRIBIK
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
1247200000XOther Technician

General Provider Information

NPI Number : 1457174856
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN GRIBIK
Provider Business Mailing Address
First Line : 6508 EL GRECO RD APT 4
Second Line :
City : ISLA VISTA
State : CA
Zip : 93117-4644
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6508 EL GRECO RD APT 4
Second Line :
City : ISLA VISTA
State : CA
Zip : 93117-4644
Country : US
Telephone Number : 724-799-7662
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2024
Last Update Date : 11/04/2024

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Directions to “ CAROLYN GRIBIK ” Practice Location

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