Individual
GRANT DAVID KEPHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
ST. JOSEPH'S MEDICAL CENTER, 1800 N. CALIFORNIA ST., STOCKTON, CA 95204
(209) 943-2000
Mailing address
1148 8TH AVE, SACRAMENTO, CA 95818-4003
(530) 864-8882
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
NA95001045
CA
Other
Enumeration date
04/08/2019
Last updated
04/08/2019
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