Individual
DR. EGBERT FITZSTEPHEN GRINAGE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A52876
CA
208000000X
Pediatrics Physician
Primary
MD192028
OR
261QP2300X
Primary Care Clinic/Center
61589
MN
261QP2300X
Primary Care Clinic/Center
A52876
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2013
Last updated
04/30/2026
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