Gerardo Grijalva
Individual provider Active NPI Non-emergency Medical Transport (VAN) · Douglas, AZ
NPI 1851700488 · NPPES record last updated Aug 7, 2014
Key facts
- NPI
- 1851700488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Non-emergency Medical Transport (VAN) 343900000X
- License
- D00985585 (AZ)
- Practice address
- 2714 E 6TH St
Douglas, AZ 85607 - Phone
- (520) 368-6937
- NPI assigned
- Aug 7, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D00985585 | AZ | MD | Non-emergency Medical Transport (VAN) |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-emergency Medical Transport (VAN) | 343900000X | D00985585 | AZ | Yes |
Addresses
Primary practice location
2714 E 6TH St
Douglas, AZ 85607
Mailing address
2714 E 6TH St
Douglas, AZ 85607-3526
Phone (520) 368-6937
Other providers in Douglas, AZ
- Genoa Healthcare LLC
- Kristine L. Gomez
- Grand Canyon State Inpatient Services
- Dianey Andrea Grijalva
- Elizabeth Grijalva
- Jill M. Hamilton
- Haven of Douglas, LLC
- Helping Ourselves Pursue Enrichment, Inc.
- Debra Hill
- Holistic Healing and Wellness Center, P.C.
All providers in Douglas, AZ · Non-emergency Medical Transport (VAN) in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.