DR. JERROLD I GRAYSON M.D. NPI 1134184476

NPI Information

  • NPI: 1134184476
  • Provider Name: DR. JERROLD I GRAYSON, M.D.
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • Address: 650 SANITARIUM RD
    DEER PARK, CA
    ZIP 94576
  • Phone: (707) 963-6430

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NPI Details

DR. Jerrold I Grayson, M.D. is a diagnostic radiology radiology in Deer Park, CA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Jerrold I Grayson, M.D. NPI is 1134184476. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

650 SANITARIUM RD
DEER PARK, CA
ZIP 94576-714
Phone: (707) 963-6430

The enumeration date for this NPI number is 4/19/2006 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyG26478CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F14456MEDICARE UPINCALIFORNIA
200G264780MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAINDIVIDUAL PROV NUMBER
300G264780MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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