Provider Demographics
NPI:1164566279
Name:GRAMAJE, FRANCES B (PT)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:B
Last Name:GRAMAJE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4702 LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6902
Mailing Address - Country:US
Mailing Address - Phone:310-306-1478
Mailing Address - Fax:310-306-6008
Practice Address - Street 1:4702 LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-6902
Practice Address - Country:US
Practice Address - Phone:310-306-1478
Practice Address - Fax:310-306-6008
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33318225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT33318AMedicare PIN
CAW17215CMedicare PIN