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General NPI Number Information
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NPI Number | 1881578573
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Entity Type | Individual
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Provider Name | ERIK D GRANADOS
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Gender | Male
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 09/07/2025
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Provider Practice Location Address
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Address Line | 7211 VAN NUYS BLVD
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City | VAN NUYS
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State | CA
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Zip | 91405-2256
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Country | US
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Telephone | 818-648-0116
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Fax |
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Provider Business Mailing Address
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Address Line | 27560 MARTA LN APT 201
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City | CANYON COUNTRY
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State | CA
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Zip | 91387-6556
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Country | US
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Telephone | 818-648-0116
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95036678
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License Number State | CA
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