Individual
IAN P GRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1335 BUENAVENTURA BLVD STE 204, REDDING, CA 96001-0160
(530) 243-5551
(530) 245-0572
Mailing address
1335 BUENAVENTURA BLVD STE 204, REDDING, CA 96001-0160
(530) 243-5551
(530) 245-0572
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G73597
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G735970
—
CA
Enumeration date
07/26/2006
Last updated
01/17/2014
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