Individual
SAMANTHA JANE GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2295 S VINEYARD AVE, ONTARIO, CA 91761-7925
(909) 724-5000
Mailing address
1310 WOODVALE DR, CORONA, CA 92879-8845
(951) 520-6122
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
95232677
CA
Other
Enumeration date
12/04/2025
Last updated
12/04/2025
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