Provider Demographics
NPI:1659842532
Name:GRUBER, HARRY EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:EDWARD
Last Name:GRUBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4511 RANCHO DEL MAR TRL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-5207
Mailing Address - Country:US
Mailing Address - Phone:858-775-8348
Mailing Address - Fax:
Practice Address - Street 1:4511 RANCHO DEL MAR TRL
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-5207
Practice Address - Country:US
Practice Address - Phone:858-775-8348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37515207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology