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DR. JERROLD I GRAYSON M.D.
Diagnostic Radiology >> Radiology >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1134184476
Individual Registrant:DR. JERROLD I GRAYSON M.D.
Gender: M
Gender: M
Location and contact information for practice:
650 SANITARIUM RD DEER PARK, CA 94576-9714 US
Tel: 707-963-6430 Fax: --
Tel: 707-963-6430 Fax: --
Contact information for business:
PO BOX 3222 NAPA, CA 94558-0293 US
Tel: 707-261-7821 Fax: 707-256-3508
Tel: 707-261-7821 Fax: 707-256-3508
Registration Information:
NPI: 1134184476
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 2085R0202X | Allopathic & Osteopathic Physicians Radiology Diagnostic Radiology | CA | G26478 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 00G264780 | CA | 05 |
