MEDICARE: DR. CAROL J GRABOWSKI M.D., INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	G54514	CA

General Provider Information

NPI Number	:	1043280373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL J GRABOWSKI M.D., INC

Provider Business Mailing Address
First Line	:	2865 ATLANTIC AVE
Second Line	:	SUITE 204
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1740
Country	:	US
Telephone Number	:	562-595-5056
Fax Number	:	562-595-6295

Provider Business Practice Location Address
First Line	:	2865 ATLANTIC AVENUE
Second Line	:	SUITE 204
City	:	LONG BEACH
State	:	CA
Zip	:	90806
Country	:	US
Telephone Number	:	562-595-5056
Fax Number	:	562-595-6295

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	11/03/2011

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