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Organization
MEDSTAT INC
Active
Organization
MEDSTAT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORIO L DE GRANO NP (CEO)
(818) 516-8066
Entity
Organization
Contact information
Practice address
430 PARK AVE, PORT HUENEME, CA 93041-2553
(805) 487-3881
(561) 286-5137
Mailing address
430 PARK AVE, PORT HUENEME, CA 93041-2553
(805) 487-3881
(561) 286-5137
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
07/06/2018
Last updated
12/27/2023
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