Individual provider Active NPI

Brian Joseph Granacki, ARRT

  • Radiography Radiologic Technologist
  • San Diego, CA
National Provider Identifier
1407038284
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiography Radiologic TechnologistTaxonomy code 2471C3402X
License
RHT00092789 Issued in CA
Practice address
1450 Chalcedony St Apt 9
San Diego, CA 92109-2130
Phone
(619) 316-6770
NPI assigned
Dec 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiography Radiologic Technologist 2471C3402X RHT00092789 CA Primary

Addresses

Primary practice location

1450 Chalcedony St Apt 9
San Diego, CA 92109-2130

Mailing address

1450 Chalcedony St Apt 9
San Diego, CA 92109-2130
Phone (619) 316-6770

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

State licenses

LicenseStateTypeSpecialty
RHT00092789CAMDRadiography Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1407038284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 CHALCEDONY ST APT 9",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921092130",
            "telephone_number": "619-316-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CHALCEDONY ST APT 9",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921092130",
            "telephone_number": "619-316-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANACKI",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "ARRT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "CA",
            "license": "RHT00092789",
            "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 Dec 3, 2007; 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.