Healthcare Provider Details

I. General information

NPI: 1780986281
Provider Name (Legal Business Name): CAROL J GRABOWSKI, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2010
Last Update Date: 12/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 ATLANTIC AVENUE SUITE 204
LONG BEACH CA
90806
US

IV. Provider business mailing address

2865 ATLANTIC AVENUE SUITE 204
LONG BEACH CA
90806
US

V. Phone/Fax

Practice location:
  • Phone: 562-595-5056
  • Fax: 562-595-6295
Mailing address:
  • Phone: 562-595-5056
  • Fax: 562-595-6295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG54514
License Number StateCA

VIII. Authorized Official

Name: DR. CAROL J GRABOWSKI
Title or Position: OWNER
Credential: M.D.
Phone: 562-595-5056