MEDICARE: GRABO UNITED INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PHY46522	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1993366	OTHER		PK

General Provider Information

NPI Number	:	1245345263
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRABO UNITED INC

Provider Business Mailing Address
First Line	:	709 N HILL ST
Second Line	:	STE 23
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-2361
Country	:	US
Telephone Number	:	213-617-0088
Fax Number	:	213-617-2988

Provider Business Practice Location Address
First Line	:	709 N HILL ST
Second Line	:	STE 23
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-2361
Country	:	US
Telephone Number	:	213-617-0088
Fax Number	:	213-617-2988

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BOB SHEN
Credential	:
Telephone Number	:	213-617-0088

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	04/10/2013

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Directions to “GRABO UNITED INC ” Practice Location

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