Provider Demographics
NPI:1659399681
Name:GRABIE, MORRIS TOBIAS (MD)
Entity Type:Individual
Prefix:
First Name:MORRIS
Middle Name:TOBIAS
Last Name:GRABIE
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 1:1301 20TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2088
Mailing Address - Country:US
Mailing Address - Phone:310-829-3639
Mailing Address - Fax:310-453-4167
Practice Address - Street 1:1301 20TH ST STE 200
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2088
Practice Address - Country:US
Practice Address - Phone:310-829-3639
Practice Address - Fax:310-453-4167
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34196207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0063610Medicaid
CAZZZ24192ZOtherBLUE SHIELD
CA00G341960OtherMEDICAL PPIN #
CA00G341960Medicaid
CAGR0063610Medicaid
CAWG34196CMedicare PIN