Provider Demographics
NPI:1952679573
Name:JAMES S GRACER MD MC
Entity Type:Organization
Organization Name:JAMES S GRACER MD MC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:GRACER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-253-0567
Mailing Address - Street 1:7 SANTA MARIA WAY
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2604
Mailing Address - Country:US
Mailing Address - Phone:925-253-0567
Mailing Address - Fax:925-253-7908
Practice Address - Street 1:7 SANTA MARIA WAY
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2604
Practice Address - Country:US
Practice Address - Phone:925-253-0567
Practice Address - Fax:925-253-7908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG036442261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)