Individual
DEBORAH GRACE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16124 KASOTA RD STE C, APPLE VALLEY, CA 92307-2232
(760) 780-0382
Mailing address
PO BOX 10096, FORT IRWIN, CA 92310-0096
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-12904
NC
363A00000X
Physician Assistant
Primary
PA64348
CA
Other
Enumeration date
05/04/2023
Last updated
05/27/2025
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