DR. JERROLD I GRAYSON (NPI# 1134184476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134184476 |
| Entity Type | Individual |
| Full Name | DR. JERROLD I GRAYSON |
| Credential | M.D. |
| Practice Address |
650 Sanitarium Rd Deer Park CA 94576-9714 |
| Mailing Address |
Po Box 3222 Napa CA 94558-0293 |
| Practice Telephone | 7079636430 |
| Mailing Telephone | 7072617821 |
| Mailing Fax Number | 7072563508 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
G26478 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G264780 | 05 |
| Street Address |
650 SANITARIUM RD |
| City | DEER PARK |
| State | CA |
| Zip Code | 94576-9714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467511881 | Lee Austin | Registered Nurse | 650 Sanitarium Rd, Deer Park, CA 94576 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679625891 | Michael R. Bartos | Psychiatry & Neurology | 19270 Sonoma Highway, Sonoma, CA 94576 | 2007-01-17 |
| 1235180951 | Lyons & Popple Medical Corp | Anesthesiology | 650 Sanitarium, Deer Park, CA 94576 | 2006-05-15 |
| 1285609172 | John E. Hodgkin | Internal Medicine | 660 Sanitarium Rd, Suite 502, Deer Park, CA 94576-9714 | 2006-02-22 |
| 1154397321 | Daniel U. Skeoch | Orthopaedic Surgery | 660 Sanitarium Rd, Suite 204, Deer Park, CA 94576-9714 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184223729 | Fabienne Noreva Nelson | Behavior Technician | 116 Fillmore Ave, Deer Park, NY 11729-7004 | 2020-10-24 |
| 1407454481 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 1900 The Arches Cir, Deer Park, NY 11729-7075 | 2020-10-13 |
| 1538766902 | Monique Abarca | Registered Nurse | 13 Westwood Ave, Deer Park, NY 11729-2805 | 2020-10-07 |
| 1053924290 | Melanie Kay Shaul | Doula | 316 W Bridges Rd, Deer Park, WA 99006-8174 | 2020-08-27 |
| 1245849850 | William M Icard Jr. | Emergency Medical Technician, Basic | 1679 County Road H, Deer Park, WI 54007-7102 | 2020-07-29 |
| 1447869409 | Diana Bosinski | Physical Therapy Assistant | 84 W 13th St, Deer Park, NY 11729-4018 | 2020-07-27 |
| 1639797392 | Maribel Mora | Massage Therapist | 2011 Deer Park Ave, Deer Park, NY 11729-2733 | 2020-07-09 |
| 1710505599 | Uttara Suresh | Dentist | 3702 Center St, Deer Park, TX 77536-6104 | 2020-07-08 |
| 1245858380 | Vashon R Coe | Counselor | 11 E H St Ste F, Deer Park, WA 99006-7130 | 2020-07-06 |
| 1184241960 | Princess Davis | Licensed Practical Nurse | 225 Tell Ave, Deer Park, NY 11729-7023 | 2020-06-29 |
| Find all providers in DEER PARK | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225093081 | Open Advanced Mri of Deer Park, LLC | Radiology | 20530 N Rand Rd, Suite 350, Deer Park, IL 60010-7233 | 2006-04-17 |
| 1013917301 | Ron Mark | Radiology | 2103 Deer Park Ave, Deer Park, NY 11729-1319 | 2005-07-28 |
| 1184028201 | Pavilion Radiology PC | Radiology | 2103 Deer Park Ave, Deer Park, NY 11729-1319 | 2014-10-17 |
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| 1548892276 | Alvarado Radiology Group Inc, A Professional Corporation | Radiology | 13700 Marina Pointe Dr Unit 430, Marina Del Rey, CA 90292-9277 | 2020-02-11 |
| 1710518535 | Health Diagnostics of California A Professional Corporation | Radiology | 1690 Barton Rd Ste 107, Redlands, CA 92373-4230 | 2020-01-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.