Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | C35530 | CA |
NPI | 1609131697 |
---|---|
Provider Name | Dr. Dan M Granoff |
First Address | Oakland, CA 94609-1673 |
Second Address | Oakland, CA 94609-1673 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2012 |
Last Update Date | 06/07/2012 |