Provider Demographics
NPI:1780765859
Name:GRACER, JAMES STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STEPHEN
Last Name:GRACER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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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
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2011-10-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG364422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA46686Medicare UPIN
CA00G364420Medicare ID - Type Unspecified