Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | C154783 | CA |
N | 208000000X | Pediatrician | ME98660 | FL |
N | 2080P0210X | Pediatric Nephrologist | ME98660 | FL |
NPI | 1467576900 |
---|---|
Provider Name | Maricor C Grio |
First Address | Mission Hills, CA 91346-9602 |
Second Address | Mission Hills, CA 91345-1116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 23/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
278709100 | (05) | FL |