Doctor Name: | MR. WILLIAM ALFONSO GRANILLO |
NPI Number: | 1356538763 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHYSICIAN ASSISTAN T |
License Number: | 10807 |
Business Practice Address: | 888 N Alta Ave Dinuba, CA - 936183089 |
Business Phone Number: | 5595951000 |
Business Fax Number: | 5595916322 |
Mailing Address: | 4690 N Bengston Ave, FRESNO |
State: | CA |
Postal Code: | 937050309 |
Phone Number: | 5592261500 |
Fax Number: | 5592261500 |
NPI Enumeration Date: | 09/29/2007 |
NPI Last Update Date: | 09/29/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 10807 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |