David Grisham, OD, MS, FAAO,FCOVD-A

Primary specialty

OptometristTaxonomy code 152W00000X

License

5110 Issued in CA

Practice address

615 B St
Suite 2
San Rafael, CA 94901-3805

Phone

(415) 459-2020

Fax

(415) 459-2021

NPI assigned

Jul 29, 2011

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 7

Addresses

Other names 1

• Dr. John David Grisham Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1326326091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 B ST",
            "address_2": "SUITE 2",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013805",
            "telephone_number": "415-459-2020",
            "fax_number": "415-459-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 B ST",
            "address_2": "SUITE 2",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013805",
            "telephone_number": "415-459-2020",
            "fax_number": "415-459-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISHAM",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "OD, MS, FAAO,FCOVD-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-29",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "5110",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "5110",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "CA",
            "license": "5110",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "5110",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "CA",
            "license": "5110",
            "primary": false
        },
        {
            "code": "156FX1100X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "CA",
            "license": "5110",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "GRISHAM",
            "middle_name": "DAVID",
            "prefix": "DR.",
            "credential": "OD,MS,FAAO,FCOVA-A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ashley Copeland Griggs
• Christina Grijalva
• Evelyn Grimaldi
• Robin Jane Grimm, CAS
• Nicole Renee Grinsell
• Christian Gronbeck III, MD
• Stephen M Gross, M.A.
• Sarah Grossi, MSW
• Rebecca Grossman
• Carin Grove, MA, MFT

• Optometrist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.