Individual
MR. JUSTIN DORIAN GREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 THE ALAMEDA, ALLIANCE FOR COMMUNITY CARE, SAN JOSE, CA 95126-1136
(408) 261-7777
(408) 554-9960
Mailing address
2001 THE ALAMEDA, ALLIANCE FOR COMMUNITY CARE, SAN JOSE, CA 95126-1136
(408) 261-7777
(408) 554-9960
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
G65957
CA
2084P0800X
Psychiatry Physician
Primary
G65957
CA
2084P0802X
Addiction Psychiatry Physician
G65957
CA
2084P0804X
Child & Adolescent Psychiatry Physician
G65957
CA
2084P0805X
Geriatric Psychiatry Physician
G65957
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G659571
PPIN
—
Enumeration date
10/02/2006
Last updated
03/19/2008
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