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NPI Code Detail

MEDICARE: LAWRENCE GRANADER M.D.

MEDICARE: LAWRENCE GRANADER M.D.
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
1208000000XPediatrics PhysicianG38341CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275644155
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAWRENCE GRANADER M.D.
Provider Business Mailing Address
First Line : 1647 VALENCIA ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94110-5012
Country : US
Telephone Number : 415-647-3666
Fax Number :
Provider Business Practice Location Address
First Line : 1647 VALENCIA ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94110-5012
Country : US
Telephone Number : 415-647-3666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/15/2010

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Directions to “ LAWRENCE GRANADER M.D.” Practice Location

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