Individual
GREGG K. OMURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 WELLINGTON AVENUE, GRAND JUNCTION, CO 81501-5517
(970) 241-6011
(970) 241-4650
Mailing address
1120 WELLINGTON AVENUE, PO BOX 10700, GRAND JUNCTION, CO 81502-5517
(970) 241-6011
(970) 241-4650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22815
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01228154
—
CO
Enumeration date
11/28/2005
Last updated
09/30/2014
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