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Export Provider Record NPI 1063611762
Tamara GrisalesM.D.
Active
NPI Number1063611762
NPI TypeNPI-1 Individual
SpecialtyObstetrics & Gynecology
Provider Details
NPI1063611762
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2007-07-12
Last Updated2024-10-15
Mailing Address5767 W Century Blvd, Suite 400
Los Angeles, CA 90045-5631
United States
Phone: (310) 301-8707
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Primary Practice Address200 Ucla Medical Plz Ste 140
Los Angeles, CA 90095-1437
United States
Phone: (310) 794-7274
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No207VF0040X – Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic SurgeryCAA108105
Yes207V00000X – Obstetrics & GynecologyCAA108105
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About NPI 1063611762

Tamara Grisales M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1063611762. The primary specialty listed is Obstetrics & Gynecology. The provider is located in Los Angeles, CA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-07-12. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1063611762?

NPI 1063611762 belongs to Tamara Grisales M.D., a Obstetrics & Gynecology in Los Angeles, CA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1063611762 active?

The current status of NPI 1063611762 in the NPPES registry is Active. The record was last updated on 2024-10-15.

What specialty is NPI 1063611762?

NPI 1063611762 is classified under the taxonomy Obstetrics & Gynecology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1063611762?

You can verify NPI 1063611762 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1063611762?

The primary practice address on file for NPI 1063611762 is 200 Ucla Medical Plz Ste 140, Los Angeles, CA 90095-1437. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1063611762 issued?

NPI 1063611762 was first issued (enumerated) on 2007-07-12. The NPPES record was last updated on 2024-10-15.

Practice Location Map

Tamara Grisales is located at 200 Ucla Medical Plz Ste 140, Los Angeles, CA. Use the map below to find directions or verify the practice location.

📍 200 Ucla Medical Plz Ste 140, Los Angeles, CA 90095-1437  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Tamara Grisales. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1063611762. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic SurgeryA108105CA
Obstetrics & GynecologyA108105CA
Data Verified from CMS NPPES Last synced: 2026-06-17 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162