MR. FREDERIC GRANNIS (NPI# 1598773582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598773582 |
| Entity Type | Individual |
| Full Name | MR. FREDERIC GRANNIS |
| Credential | MD |
| Practice Address |
1500 E Duarte Rd Duarte CA 91010 |
| Mailing Address |
1333 S. Mayflower Ave., 2nd Floor Monrovia CA 91016-4066 |
| Practice Telephone | 6263598111 |
| Mailing Telephone | 6267753514 |
| Mailing Fax Number | 6264083911 |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2015-08-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086X0206X |
Surgery Specialization: Surgical Oncology |
G36693 | CA | Allopathic & Osteopathic Physicians |
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | G36693 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G386930 | 05 |
| Street Address |
1500 E DUARTE RD |
| City | DUARTE |
| State | CA |
| Zip Code | 91010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598731820 | John Hosei Yim | Surgery | 1500 E Duarte Rd, Duarte, CA 91010-3012 | 2006-02-27 |
| 1568989739 | Susan Shehayeb | Genetic Counselor, MS | 1500 E Duarte Rd, Duarte, CA 91010 | 2017-08-28 |
| 1992157325 | Bekir Suveyd | Internal Medicine | 1500 E Duarte Rd, Endocrinology, Gonda South Building, Suite 1011a, Duarte, CA 91010 | 2016-07-09 |
| 1548689649 | Jennifer Sarah Baecker | Nurse Practitioner | 1500 E Duarte Rd, Duarte, CA 91010 | 2014-04-16 |
| 1295176394 | Razmig Vatche Babikian | Registered Nurse | 1500 E Duarte Rd, Duarte, CA 91010-3012 | 2013-07-17 |
| 1902197254 | Mari Bozoghlanian | Radiology | 1500 E Duarte Rd, Helford Hospital, Rm 1300, Duarte, CA 91010 | 2011-04-20 |
| 1972828366 | Jamie Green Rand | Surgery | 1500 E Duarte Rd, Duarte, CA 91010-3012 | 2010-03-29 |
| 1053565143 | Lee Zuckerman | Orthopaedic Surgery | 1500 E Duarte Rd, Duarte, CA 91010-3012 | 2008-11-16 |
| 1033368642 | Finly Zachariah | Family Medicine | 1500 E Duarte Rd, Department of Supportive Care, Duarte, CA 91010-3012 | 2008-09-18 |
| 1891965836 | Lydia Helen Mormann | Nurse Practitioner | 1500 E Duarte Rd, Duarte, CA 91010 | 2008-03-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386266849 | Cheyenne King | Student in an Organized Health Care Education/Training Program | 1801 Huntington Drive, Duarte, Ca 91010, Duarte, CA 91010 | 2020-05-07 |
| 1114578028 | Cristian Gonzalez | Case Manager/Care Coordinator | 2250 E Foothill Ave, Pasadena, CA 91010 | 2019-09-23 |
| 1366932378 | Maisie Madrid | Marriage & Family Therapist | 1801 Huntington Drive, Duarte, CA 91010 | 2018-05-15 |
| 1598289571 | Bertha Maria Torres | Social Worker | 938 E. Huntington Drive, Unit A, Duarte, CA 91010 | 2017-08-01 |
| 1598292286 | Sheila Ramirez | Occupational Therapy Assistant | 2302 Citrus View Ave, Duarte, CA 91010 | 2017-05-12 |
| 1982059556 | Patricia Mendoza | Case Manager/Care Coordinator | 2502 E.huntington Dr., Duarte, CA 91010 | 2016-05-02 |
| 1770966178 | Sinziana Dumitra | Surgery | 1500 Durate Road California, Mob L001, Duarte, CA 91010 | 2015-07-02 |
| 1477940161 | Jin Sun L Bitar | Internal Medicine | 1500 Duarte Rd # Wing4, Duarte, CA 91010 | 2015-04-20 |
| 1659625622 | Jeanette Marie Petermann | Nurse Practitioner | 1036 East Huntington Drive, Duarte, CA 91010 | 2012-10-30 |
| 1649534397 | Nathaniel J Khoe Dds. Inc | Dentist | 1016 Huntington Drive, Duarte, CA 91010 | 2012-06-27 |
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| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023147014 | Jae Yul Kim | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2007-03-05 |
| 1760566079 | Chelvapilla Venkata Gunupati | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1500 E. Duarte Rd., Duarte, CA 91010-3200 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598370728 | North County Cvt Surgery Associates | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3156 Vista Way Ste 100, Oceanside, CA 92056-3694 | 2020-09-14 |
| 1417560756 | Valiana Vascular Institute Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2501 E Chapman Ave Ste 220, Fullerton, CA 92831-3108 | 2020-08-26 |
| 1891252474 | Miguel Puig Md A Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1430 Esplanade Ste 10, Chico, CA 95926-3366 | 2019-03-01 |
| 1598247991 | Pavel V Petrik Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1331 W Avenue J Ste 203, Lancaster, CA 93534-2954 | 2018-08-31 |
| 1942797378 | Sharon A Bogerty Md Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 105 N Bascom Ave Ste 101b, San Jose, CA 95128-1811 | 2018-04-20 |
| 1992231112 | Samer Kanaan Md A Professional Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 27451 Los Altos, Suite 290, Mission Viejo, CA 92691 | 2017-05-08 |
| 1073065512 | Central California Chest Surgery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 729 N Medical Center Dr W Ste 223, Clovis, CA 93611-6885 | 2016-11-01 |
| 1407214612 | George Arnold Mulder | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1150 Laurel St, Pasadena, CA 91103-2329 | 2016-02-02 |
| 1760849905 | Steven R Gundry Md Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 555 E Tachevah Dr Ste 3w103, Palm Springs, CA 92262-5747 | 2016-01-19 |
| 1386018687 | Riyad Youssef Tarazi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9120 Judicial Dr, Apt 7522, San Diego, CA 92122-6700 | 2015-11-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.