David Jose Granados Rodriguez, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95023930 Issued in CA

Practice address

625 Garnet St
Imperial, CA 92251-2516

Phone

(760) 457-1491

NPI assigned

Aug 23, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Tyson Medical Inc

  • Urgent Care Clinic/Center
  • El Centro, CA
  • NPI 1376053843
  NPD (past)
• Tyson Medical Inc

  • Family Medicine Physician
  • Calexico, CA
  • NPI 1467241570
  NPD (past)

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1609650472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 GARNET ST",
            "city": "IMPERIAL",
            "state": "CA",
            "postal_code": "922512516",
            "telephone_number": "760-457-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 GARNET ST",
            "city": "IMPERIAL",
            "state": "CA",
            "postal_code": "922512516",
            "telephone_number": "760-457-1491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "DAVID JOSE GRANADOS",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Cervantes Ramos, PHARM.D.
• Benjamin Reisin, MFC
• Anissa Rioseco
• Mitchelle Rivas
• Dania Abigail Rodriguez
• Melissa Rodriguez
• Giselle Rojas
• Jessica Rojas
• Roxanne Romero
• Sandra Romero

• Family Nurse Practitioner in Imperial, CA
• Providers in Imperial, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.