Individual
DR. EGBERT FITZSTEPHEN GRINAGE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 MAIN STREET, INNERCARE -BRAWLEY, BRAWLEY, CA 92227
(760) 344-6741
(760) 344-6128
Mailing address
900 MAIN STREET, INNERCARE, BRAWLEY, CA 92227
(760) 344-6741
(760) 344-6128
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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