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Individual

JUSTIN N GRAMMY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1428 PHILLIPS LN STE 203, SAN LUIS OBISPO, CA 93401-2551
(805) 543-4407
(805) 543-4587
Mailing address
PO BOX 12460, SAN LUIS OBISPO, CA 93406-2460
(805) 543-4407
(805) 543-4587

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
16620
CA
207R00000X
Internal Medicine Physician
OS018634
PA
208M00000X
Hospitalist Physician
Primary
16620
CA

Other

Enumeration date
06/07/2013
Last updated
11/17/2021
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