Provider Demographics
NPI:1235190620
Name:GRANDINETTI, GAIL MARIE (DPM)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:MARIE
Last Name:GRANDINETTI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 WILDFLOWER CT
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-3524
Mailing Address - Country:US
Mailing Address - Phone:415-310-8321
Mailing Address - Fax:415-585-2748
Practice Address - Street 1:3575 GEARY BLVD
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3212
Practice Address - Country:US
Practice Address - Phone:415-353-4900
Practice Address - Fax:415-353-8101
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3453213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
480010707OtherRAILROAD RETIREMENT
CA000E34532Medicaid
CA00034532Medicaid
T97427Medicare UPIN
CA00034532Medicaid
CA000E34532Medicaid
CA000E34531Medicare PIN
480010707OtherRAILROAD RETIREMENT