Healthcare Provider Details

I. General information

NPI: 1285853697
Provider Name (Legal Business Name): ANGELA N GRASSER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 11/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S MADERA AVE
KERMAN CA
93630-1750
US

IV. Provider business mailing address

1000 S MADERA AVE
KERMAN CA
93630-1750
US

V. Phone/Fax

Practice location:
  • Phone: 559-846-9370
  • Fax: 559-846-9354
Mailing address:
  • Phone: 559-846-9370
  • Fax: 559-846-9354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA93433
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: