Individual provider Active NPI

Eugenio Grunvald, M.D.

  • Gastroenterology Physician
  • San Diego, CA
National Provider Identifier
1942356662
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
C50471 Issued in CA
Practice address
200 West Arbor Dr.
Mail Code - 8413
San Diego, CA 92103-8413
Phone
(619) 543-3622
Fax
(619) 543-2766
NPI assigned
Jan 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X C50471 CA Primary

Addresses

Primary practice location

200 West Arbor Dr.
Mail Code - 8413
San Diego, CA 92103-8413

Mailing address

200 West Arbor Dr.
Mail Code - 8413
San Diego, CA 92103-8413
Phone (619) 543-3622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50471CAMDMarriage & Family Therapist
C50471CAMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942356662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WEST ARBOR DR.",
            "address_2": "MAIL CODE - 8413",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921038413",
            "telephone_number": "619-543-3622",
            "fax_number": "619-543-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WEST ARBOR DR.",
            "address_2": "MAIL CODE - 8413",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921038413",
            "telephone_number": "619-543-3622",
            "fax_number": "619-543-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNVALD",
        "first_name": "EUGENIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "C50471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.