Mark Elliott Granoff
Internist Geriatric Medicine
8635 W 3rd St Suite 790w
Los Angeles
, California 90048-6101
Mark Elliott Granoff
Internist Geriatric Medicine
8635 W 3rd St Suite 790w
Los Angeles
, California 90048-6101
(310) 855-0438
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About
Features
Specialties
- Internist
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Mark Elliott Granoff
- 8635 W 3rd St Suite 790w
- Los Angeles, CA
- Zip : 90048-6101
- Fax : (310) 855-0438
- Phone : (310) 855-8081
Second Address
- Mark Elliott Granoff
- 8635 W 3rd St Suite 790w
- Los Angeles, CA
- Zip : 90048-6101
- Fax : (310) 855-0438
- Phone : (310) 855-8081
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FAQs
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Is Mark Elliott Granoff a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207R00000X | Internist | G30036 | CA |
| Y | 111NI0900X | Internist | G30036 | CA |
| N | 207RG0300X | Geriatric Medicine | G30036 | CA |
National Provider Identifier
| NPI | 1124058474 |
|---|---|
| Provider Name | Mark Elliott Granoff |
| First Address | Los Angeles, CA 90048-6101 |
| Second Address | Los Angeles, CA 90048-6101 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/07/2006 |
| Last Update Date | 20/06/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00G300360 | BLUE SHIELD (01) | CA |
| 110021538 | RAILROAD MEDICARE (01) | CA |
| 4042708 | AETNA (01) | CA |
| A44268 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.