MEDICARE: DR. STEVEN RICHARD GRABOFF MD

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	207X00000X	Orthopaedic Surgery Physician	G45318	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00G453180	OTHER	CA	MEDICAL

General Provider Information

NPI Number	:	1518037829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN RICHARD GRABOFF MD

Provider Business Mailing Address
First Line	:	17752 BEACH BLVD
Second Line	:	SUITE 202
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-6807
Country	:	US
Telephone Number	:	714-843-0019
Fax Number	:	714-841-1280

Provider Business Practice Location Address
First Line	:	17752 BEACH BLVD
Second Line	:	SUITE 202
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-6807
Country	:	US
Telephone Number	:	714-843-0019
Fax Number	:	714-841-1280

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	07/08/2007

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