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Individual

DR. DAVID A. GRANOVETTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6203 SAN IGNACIO AVE STE 110, SAN JOSE, CA 95119-1358
(660) 245-2858
Mailing address
6203 SAN IGNACIO AVE STE 110, SAN JOSE, CA 95119-1358
(669) 245-2858

Taxonomy

Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
G67173
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G671730
CA
Enumeration date
10/27/2006
Last updated
03/12/2026
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