Masaoka, Grant Roger
Masaoka, Grant Roger is an individual health care provider with primary practice located at 1781 W Romneya Dr Suite E, Anaheim CA 92801-1818. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Masaoka, Grant Roger can be contacted via phone (714) 774-0414.Contact Information
Primary practice address
1781 W Romneya Dr Suite E
Anaheim CA 92801-1818
Phone: (714) 774-0414
Fax: (714) 774-0494
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | G19094 | California |
Profile Details
| NPI number | 1780677120 |
|---|---|
| LBN Legal business name | Masaoka, Grant Roger |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2005 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780677120 | NPPES |
| California | MEDICAID | 00G190940 |
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