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General NPI Number Information
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NPI Number | 1114298338
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Entity Type | Individual
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Provider Name | LOUIS HUMBERTO GRASS III CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 937 FRANKLIN BLVD
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City | LEMOORE
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State | CA
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Zip | 93246-4700
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Country | US
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Telephone | 559-998-2648
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 555191
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City | CAMP PENDLETON
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State | CA
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Zip | 92055-5191
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Country | US
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Telephone | 760-685-1296
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 631223
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WF0300X
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Taxonomy Name | Flight Registered Nurse
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License Number | RN 3218152
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN3218152
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 87789
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | NA95001504
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License Number State | CA
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