Provider Demographics
NPI:1952328494
Name:GRIGSBY, ERIC J (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:GRIGSBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 5510
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94581-0510
Mailing Address - Country:US
Mailing Address - Phone:707-252-9666
Mailing Address - Fax:707-258-2780
Practice Address - Street 1:3434 VILLA LN
Practice Address - Street 2:SUITE 150
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6405
Practice Address - Country:US
Practice Address - Phone:707-252-9666
Practice Address - Fax:707-258-2780
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2011-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG648480208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G648480Medicaid
CAE36253Medicare UPIN
CA00G648480Medicare ID - Type UnspecifiedERIC J. GRIGSBY, MD