| James Santiago Grisolia, M.d. Inc | |
|
4033 3rd Ave Suite 410 San Diego CA 92103-2117 | |
| (619) 297-1155 | |
| Not Available |
| Full Name | James Santiago Grisolia, M.d. Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4033 3rd Ave, San Diego, California |
| Authorized Official Name and Position | James Santiago Grisolia (PRESENT) |
| Authorized Official Contact | 6192971155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James Santiago Grisolia, M.d. Inc 4033 3rd Ave Suite 410 San Diego CA 92103-2117 Ph: (619) 297-1155 | James Santiago Grisolia, M.d. Inc 4033 3rd Ave Suite 410 San Diego CA 92103-2117 Ph: (619) 297-1155 |
| NPI Number | 1801933684 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 05/18/2015 |
| Medicare PECOS PAC ID | 0547453631 |
|---|---|
| Medicare Enrollment ID | O20101021000537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801933684 | NPI | - | NPPES |
| 00G428840 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | G42884 (California) | Primary |
| Provider Name | James S Grisolia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336102359 PECOS PAC ID: 4688867781 Enrollment ID: I20101021000638 |
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