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Jack Gray Sample
Student in an Organized Health Care Education/Training Program in San Francisco, California
NPI 1255064572

Jack Gray Sample is a Student in an Organized Health Care Education/Training Program based in San Francisco, CA. Jack Gray Sample practices in San Francisco, CA. The NPI Number for Jack Gray Sample is 1255064572 and holds a License No. (California).

The current practice location address for Jack Gray Sample is 4210 Judah St Apt 304, San Francisco, CA and can be reached out via phone at 714-907-5033.

Location: 4210 Judah St Apt 304, San Francisco, CA, 94122-1016
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1255064572
Provider Name
Jack Gray Sample
Credential
Provider Entity Type
Individual
Gender
Male
Address
4210 Judah St Apt 304, San Francisco, CA, 94122-1016
Phone Number
714-907-5033
Fax Number
Provider Enumeration Date
07/05/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4210 Judah St Apt 304
City
San Francisco
State
California
Zip
94122-1016
Phone Number
714-907-5033
Fax Number
person
Provider Business Mailing Address Details
Address
4210 Judah St Apt 304
City
San Francisco
State
California
Zip
94122-1016
Phone Number
714-907-5033
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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