Provider Demographics
NPI:1659342624
Name:GRASSI, FRANK
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:GRASSI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8555 AERO DR
Mailing Address - Street 2:STE 104
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1744
Mailing Address - Country:US
Mailing Address - Phone:858-650-5036
Mailing Address - Fax:858-650-5039
Practice Address - Street 1:1350 S KINGS DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2134
Practice Address - Country:US
Practice Address - Phone:704-446-1242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52598207RC0200X, 207RP1001X
NC2017-00784207RC0200X
FLME108869207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP991368OtherFREEDOM
FL7468889OtherAETNA
FL14CT0OtherBCBS OF FL
FL8565682OtherCIGNA
FLP01319832OtherRR MEDICARE
FLP953890OtherOPTIMUM
FL346441OtherAVMED
FLFA133YMedicare PIN