MEDICARE: GABRIELLE GRADY DPT

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	208100000X	Physical Medicine & Rehabilitation Physician	300830	CA

General Provider Information

NPI Number	:	1821769969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLE GRADY DPT

Provider Business Mailing Address
First Line	:	1375 HAYES ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94117-1464
Country	:	US
Telephone Number	:	616-308-8572
Fax Number	:

Provider Business Practice Location Address
First Line	:	1375 HAYES ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94117-1464
Country	:	US
Telephone Number	:	616-308-8572
Fax Number	:

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

Provider Enumeration Date	:	09/27/2021
Last Update Date	:	12/09/2022

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Directions to “ GABRIELLE GRADY DPT” Practice Location

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