Individual
IDA GRANDJEAN DUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3633 LONG BEACH BLVD STE 100, LONG BEACH, CA 90807-6027
(562) 424-9000
Mailing address
3633 LONG BEACH BLVD STE 100, LONG BEACH, CA 90807-6027
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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