Active NPI
Raul Mark Miranda Grageda
- Physical Therapist
- Oakland, CA
National Provider Identifier
1821234816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 35173
- Practice address
- 7817 Oakport Street
Oakland, CA 94621 - Phone
- (510) 638-0811
- NPI assigned
- Dec 23, 2008
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 35173 | CA | Primary |
Addresses
Primary practice location
7817 Oakport Street
Oakland, CA 94621
Mailing address
885 Duncan Street
San Francisco, CA 94131
Phone (415) 796-2900
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35173 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357516800000",
"number": "1821234816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "885 DUNCAN STREET",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94131",
"telephone_number": "415-796-2900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7817 OAKPORT STREET",
"city": "OAKLAND",
"state": "CA",
"postal_code": "94621",
"telephone_number": "510-638-0811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAGEDA",
"first_name": "RAUL MARK",
"middle_name": "MIRANDA",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-23",
"last_updated": "2013-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "35173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.