Organization
RICHARD W. GRATIAN, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD WARREN GRATIAN M.D. (OWNER)
(209) 529-1275
Entity
Organization
Contact information
Practice address
1540 FLORIDA AVE, SUITE 205, MODESTO, CA 95350-4430
(209) 529-1275
(209) 529-3464
Mailing address
1540 FLORIDA AVE, SUITE 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
12/09/2008
Last updated
12/09/2008
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