Active NPI
Tomas M Grippo, M.D.
- Ophthalmology Physician
- La Jolla, CA
National Provider Identifier
1104010164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- A110833
- Practice address
- Shiley Eye Center
9415 Campus Point Drive, RM 217 MC 0946
La Jolla, CA 92093 - Phone
- (917) 679-7782
- NPI assigned
- Sep 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | A110833 | CA | Primary |
Addresses
Primary practice location
Shiley Eye Center
9415 Campus Point Drive, RM 217 MC 0946
La Jolla, CA 92093
Mailing address
Shiley Eye Center
9415 Campus Point Drive MC 0946
La Jolla, CA 92093
Phone (917) 679-7782
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A110833 | CA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271203200000",
"number": "1104010164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "SHILEY EYE CENTER",
"address_2": "9415 CAMPUS POINT DRIVE MC 0946",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "92093",
"telephone_number": "917-679-7782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SHILEY EYE CENTER",
"address_2": "9415 CAMPUS POINT DRIVE, RM 217 MC 0946",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "92093",
"telephone_number": "917-679-7782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIPPO",
"first_name": "TOMAS",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-04",
"last_updated": "2010-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "A110833",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.