Provider Demographics
NPI:1740367085
Name:ONLY GRACE INC
Entity type:Organization
Organization Name:ONLY GRACE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARI
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:MUSCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-759-6325
Mailing Address - Street 1:5535 CANCHA DE GOLF STE 101
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92091-9504
Mailing Address - Country:US
Mailing Address - Phone:858-759-6325
Mailing Address - Fax:858-759-6329
Practice Address - Street 1:5535 CANCHA DE GOLF STE 101
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA FE
Practice Address - State:CA
Practice Address - Zip Code:92091-9504
Practice Address - Country:US
Practice Address - Phone:858-759-6325
Practice Address - Fax:858-759-6329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
5089220001Medicare ID - Type Unspecified