Provider Demographics
NPI:1407182579
Name:GRAGLIA, SALLY MARIE (MD, MPH)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:MARIE
Last Name:GRAGLIA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:MARIE STEFANIA
Other - Last Name:GRAGLIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:505 PARNASSUS AVE
Mailing Address - Street 2:ROOM M24
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2204
Mailing Address - Country:US
Mailing Address - Phone:626-488-9546
Mailing Address - Fax:
Practice Address - Street 1:505 PARNASSUS AVE
Practice Address - Street 2:ROOM M24
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2204
Practice Address - Country:US
Practice Address - Phone:626-488-9546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA129640207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine