Doctor Name: | MRS. MINA GRASSO |
NPI Number: | 1043621444 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | RN350791 |
Business Practice Address: | 1113 Alta Ave Ste 210 Upland Upland, CA - 917862803 |
Business Phone Number: | 9099821074 |
Business Fax Number: | 9099823104 |
Mailing Address: | 1113 Alta Ave Ste 210, Upland UPLAND |
State: | CA |
Postal Code: | 917862803 |
Phone Number: | 9099821074 |
Fax Number: | 9099823104 |
NPI Enumeration Date: | 05/19/2014 |
NPI Last Update Date: | 05/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN350791 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |