Individual
DR. IGOR GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9001
(858) 534-3652
Mailing address
9500 GILMAN DR, MAIL CODE 0680, LA JOLLA, CA 92093-5004
(858) 534-3652
(858) 534-7723
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G18301
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G183010
—
CA
Enumeration date
07/12/2006
Last updated
07/08/2007
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