Healthcare Provider Details

I. General information

NPI: 1568942753
Provider Name (Legal Business Name): ROWENA MARIE GRAISHE RCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2018
Last Update Date: 08/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9333 IMPERIAL HWY
DOWNEY CA
90242-2812
US

IV. Provider business mailing address

9333 IMPERIAL HWY
DOWNEY CA
90242-2812
US

V. Phone/Fax

Practice location:
  • Phone: 562-957-9000
  • Fax: 562-657-7884
Mailing address:
  • Phone: 562-760-5367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRCP9658
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: