Provider Demographics
NPI:1326168857
Name:HUNTER, GRACE NARGIS (DO)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:NARGIS
Last Name:HUNTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 QUAIL RDG
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-4228
Mailing Address - Country:US
Mailing Address - Phone:949-378-1569
Mailing Address - Fax:
Practice Address - Street 1:418 QUAIL RDG
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92603-4228
Practice Address - Country:US
Practice Address - Phone:949-378-1569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8304208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation