Michelle Grino Campana, M.D.

Individual provider Active NPI Pediatrics Physician · Valencia, CA

NPI 1003075714 · NPPES record last updated Nov 5, 2019

Key facts

NPI
1003075714
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
BP10032064 (TX)
Practice address
23823 Valencia Blvd
Suite 120
Valencia, CA 91355-9513
Phone
(661) 253-4971
NPI assigned
Jun 6, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10032064TXMDPediatrics Physician

Practice roles (4 of 5)

OrganizationSpecialtyStatusNew patients
Morris Yen, MD, Inc Pediatrics Past Accepting new patients
Henry Mayo Newhall Memorial Hospital Past Accepting new patients
Santa Clarita Pediatrics Pediatrics Past Accepting new patients
Sunanda Reddy Vadapalli, MD, Inc Pediatrics Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBEGCA/Endpoint/HBEGCA

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X BP10032064 TX Yes

Addresses

Primary practice location

23823 Valencia Blvd
Suite 120
Valencia, CA 91355-9513

Mailing address

23823 Valencia Blvd
Suite 120
Valencia, CA 91355-9513
Phone (661) 253-4971

Other identifiers

IdentifierTypeStateIssuer
2195077MedicaidLA

Other names

  • Marie Michelle Antonio Grino Former name

Other providers in Valencia, CA

All providers in Valencia, CA · Pediatrics Physician in California

Sources for this page

Verify at the official NPI Registry.