Individual
DR. JERRY GRIGOROPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1524 MCHENRY AVE, SUITE 100, MODESTO, CA 95350-4500
(209) 571-6622
(209) 527-2069
Mailing address
101 PARK AVE, MODESTO, CA 95354-0556
(209) 571-6622
(209) 527-2069
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
A73614
CA
2085R0202X
Diagnostic Radiology Physician
Primary
A73614
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A736140
—
CA
Enumeration date
06/02/2006
Last updated
04/29/2008
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