Individual
DR. CHARLES GORDON GRANT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9455 CLAIREMONT MESA BLVD, SAN DIEGO, CA 92123-1297
(858) 266-5000
Mailing address
7777 WESTSIDE DR APT 262, SAN DIEGO, CA 92108-1232
(253) 886-2683
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A165716
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
04/29/2018
Last updated
07/19/2021
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