Individual
TRACY CANNON GRIKSCHEIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4650 SUNSET BLVD., MS# 100, LOS ANGELES, CA 90027-6062
(323) 669-2322
(323) 666-3466
Mailing address
6430 SUNSET BLVD., SUITE 600, LOS ANGELES, CA 90028-7900
(323) 669-2337
(323) 644-8491
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
A96712
CA
Other
Enumeration date
10/02/2006
Last updated
05/30/2019
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