Healthcare Provider Details

I. General information

NPI: 1154853034
Provider Name (Legal Business Name): GRABOWSKI & ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 05/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CASS ST STE 126
MONTEREY CA
93940-2921
US

IV. Provider business mailing address

1324 W CENTER AVE
VISALIA CA
93291-5804
US

V. Phone/Fax

Practice location:
  • Phone: 831-717-4958
  • Fax: 831-718-8127
Mailing address:
  • Phone: 559-625-3937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number07-319-19
License Number StateCA

VIII. Authorized Official

Name: MR. BRIAN EDWARD GRABOWSKI
Title or Position: CEO
Credential: BCO BADO
Phone: 559-625-3937