Active NPI
Grace Roberts, MD
- Family Medicine Physician
- San Diego, CA
National Provider Identifier
1386404440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 17717
- Practice address
- 330 Lewis St Ste 400
San Diego, CA 92103-2108 - Phone
- (858) 657-7000
- NPI assigned
- Mar 19, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 17717 | CA | Primary |
Addresses
Primary practice location
330 Lewis St Ste 400
San Diego, CA 92103-2108
Mailing address
330 Lewis St Ste 400
San Diego, CA 92103-2108
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17717 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752364800000",
"number": "1386404440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 LEWIS ST STE 400",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921032108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 LEWIS ST STE 400",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921032108",
"telephone_number": "858-657-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "GRACE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-19",
"last_updated": "2025-07-13",
"certification_date": "2025-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "CA",
"license": "17717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.