| Janette J Gray Md Inc | |
|
3636 Fifth Ave Ste 300 San Diego CA 92103-4230 | |
| (619) 814-5500 | |
| (619) 814-5544 |
| Full Name | Janette J Gray Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3636 Fifth Ave Ste 300, San Diego, California |
| Authorized Official Name and Position | Janette J Gray (MEDICAL DOCTOR) |
| Authorized Official Contact | 6198145500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Janette J Gray Md Inc 3636 Fifth Ave Ste 300 San Diego CA 92103-4230 Ph: (619) 814-5500 | Janette J Gray Md Inc 3636 Fifth Ave Ste 300 San Diego CA 92103-4230 Ph: (619) 814-5500 |
| NPI Number | 1609177294 |
|---|---|
| Provider Enumeration Date | 11/12/2010 |
| Last Update Date | 01/15/2020 |
| Medicare PECOS PAC ID | 8729319850 |
|---|---|
| Medicare Enrollment ID | O20191003002746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609177294 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Natasha R Tininenko |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225170087 PECOS PAC ID: 0345327102 Enrollment ID: I20080404000182 |
| Provider Name | Steven M Haley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1083764484 PECOS PAC ID: 5890827232 Enrollment ID: I20100720000636 |
| Provider Name | Behrang H Dehkordi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861786873 PECOS PAC ID: 8820318694 Enrollment ID: I20160801001955 |
| Provider Name | Amanda Renee Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780211300 PECOS PAC ID: 6305253709 Enrollment ID: I20210331002849 |
| Provider Name | Ketevan Jorjadze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336737840 PECOS PAC ID: 5193118537 Enrollment ID: I20220208002382 |
| Provider Name | Raymond K Herr |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1750425542 PECOS PAC ID: 4486782505 Enrollment ID: I20220411001707 |
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