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Individual

DR. GRIGORIY N PATISH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
407 POTTER ST STE A, FALLBROOK, CA 92028-3086
(760) 728-4800
(760) 728-0061
Mailing address
407 POTTER ST STE A, FALLBROOK, CA 92028-3086
(760) 728-4800
(760) 728-0061

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
25MD00298800
NJ
213E00000X
Podiatrist
N005980
NY
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
E4987
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02639412
NY
Enumeration date
06/10/2006
Last updated
03/31/2021
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