Provider Demographics
NPI:1265636013
Name:GRISELL, MARGARET KATHLEEN (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:KATHLEEN
Last Name:GRISELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 DALE RD
Mailing Address - Street 2:KAISER MODESTO MEDICAL CENTER, ORTHOPEDIC SURGERY
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9718
Mailing Address - Country:US
Mailing Address - Phone:209-735-5000
Mailing Address - Fax:
Practice Address - Street 1:4601 DALE RD
Practice Address - Street 2:KAISER MODESTO MEDICAL CENTER, ORTHOPEDIC SURGERY
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-9718
Practice Address - Country:US
Practice Address - Phone:209-735-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA116231207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery