Provider Demographics
NPI:1255317798
Name:GRILLS, CHAD (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:
Last Name:GRILLS
Suffix:
Gender:M
Credentials:PHD
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Other - Credentials:
Mailing Address - Street 1:1 JARRETT WHITE RD
Mailing Address - Street 2:TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
Mailing Address - City:TRIPLER AMC
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5001
Mailing Address - Country:US
Mailing Address - Phone:808-433-6661
Mailing Address - Fax:808-433-1551
Practice Address - Street 1:1 JARRETT WHITE RD
Practice Address - Street 2:TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
Practice Address - City:TRIPLER AMC
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-6661
Practice Address - Fax:808-433-1551
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2023-08-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIPSY890103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI100545Medicare ID - Type UnspecifiedNAS MEDICARE PART B