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Contact Information

GRADY B HUCKABY JR, MD
4050 BARRANCA PKWY
SUITE 270
IRVINE, CA92604-7706
 Phone: 949-559-5601
 Fax: 949-559-7115
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for GRADY B HUCKABY JR · (Male)

NPI Number 1093840688
Status Active
Credentials MD
Entity Individual
Enumeration date 02/22/2007
Last updated 11/30/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • CA License # A31495
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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