Provider Demographics
NPI:1205229549
Name:GRABOWSKI & ASSOCIATES INC
Entity Type:Organization
Organization Name:GRABOWSKI & ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:GRABOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:BCO
Authorized Official - Phone:916-456-3937
Mailing Address - Street 1:1324 W CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-5804
Mailing Address - Country:US
Mailing Address - Phone:916-456-3937
Mailing Address - Fax:
Practice Address - Street 1:5340 ELVAS AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-2345
Practice Address - Country:US
Practice Address - Phone:916-456-3937
Practice Address - Fax:916-456-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA07-319-13335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1528234424Medicaid