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General NPI Number Information
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NPI Number | 1619279239
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Entity Type | Individual
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Provider Name | MICHAEL RICHARD GRAZIER M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/02/2010
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Last Update Date | 01/10/2014
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Provider Practice Location Address
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Address Line | 2100 POWELL ST STE 920
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City | EMERYVILLE
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State | CA
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Zip | 94608-1844
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Country | US
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Telephone | 510-350-2649
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 23RD ST
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City | SACRAMENTO
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State | CA
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Zip | 95816-4916
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Country | US
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Telephone | 559-283-3226
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A115788
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License Number State | CA
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