Individual
VALERIE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 S GAFFEY ST, SAN PEDRO, CA 90731-4628
(310) 548-0201
(310) 547-3340
Mailing address
1600 S GAFFEY ST, SAN PEDRO, CA 90731-4628
(310) 548-0201
(310) 547-3340
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G64361
CA
208D00000X
General Practice Physician
Primary
G64361
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G643610
—
CA
Enumeration date
06/14/2006
Last updated
09/25/2020
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