Provider Demographics
NPI:1003127077
Name:GRANADOS, MARIA ISABELLE
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ISABELLE
Last Name:GRANADOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 W OLYMPIC BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-1400
Mailing Address - Country:US
Mailing Address - Phone:213-553-1800
Mailing Address - Fax:213-553-1822
Practice Address - Street 1:605 W OLYMPIC BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-1400
Practice Address - Country:US
Practice Address - Phone:213-553-1800
Practice Address - Fax:213-553-1822
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator