Individual
GRANT YIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
975 SERENO DR, VALLEJO, CA 94589-2441
(707) 651-1000
Mailing address
975 SERENO DR, VALLEJO, CA 94589-2441
(707) 651-1000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
625519
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95000073
CA
Other
Enumeration date
12/07/2016
Last updated
02/11/2022
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