Individual
MR. KENNETH R GRABOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 N TUSTIN AVE, STE 100, SANTA ANA, CA 92705-3508
(714) 542-5999
Mailing address
1200 N TUSTIN AVE, STE 100, SANTA ANA, CA 92705-3508
(714) 542-5999
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
G66481
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183774600
DEPT OF LABOR
CA
05
—
G66481
—
CA
Enumeration date
08/10/2006
Last updated
10/13/2010
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