Individual
DR. RICHARD WARREN GRATIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1540 FLORIDA AVE, STE 205, MODESTO, CA 95350-4430
(209) 529-1275
(209) 529-3464
Mailing address
1540 FLORIDA AVE, STE 205, MODESTO, CA 95350-4430
(209) 529-1275
(209) 529-3464
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
G36443
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G364430
—
CA
Enumeration date
05/22/2006
Last updated
03/17/2008
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