Provider Demographics
NPI:1518037829
Name:GRABOFF, STEVEN RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RICHARD
Last Name:GRABOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17752 BEACH BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6807
Mailing Address - Country:US
Mailing Address - Phone:714-843-0019
Mailing Address - Fax:714-841-1280
Practice Address - Street 1:17752 BEACH BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6807
Practice Address - Country:US
Practice Address - Phone:714-843-0019
Practice Address - Fax:714-841-1280
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG45318207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G453180OtherMEDICAL
A92569Medicare UPIN
CAA92569Medicare ID - Type Unspecified