Richard W. Gratian, M.D.

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

G36443 Issued in CA

Legal business name

RICHARD W. GRATIAN, M.D.

Practice address

1540 Florida Ave
Suite 205
Modesto, CA 95350-4430

Phone

(209) 529-1275

Fax

(209) 529-3464

NPI assigned

Dec 9, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Richard Warren Gratian, M.D.

Title

Owner

Phone

(209) 529-1275

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1609011469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 FLORIDA AVE",
            "address_2": "SUITE 205",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504430",
            "telephone_number": "209-529-1275",
            "fax_number": "209-529-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 FLORIDA AVE",
            "address_2": "SUITE 205",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504430",
            "telephone_number": "209-529-1275",
            "fax_number": "209-529-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD W. GRATIAN, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-09",
        "last_updated": "2008-12-09",
        "status": "A",
        "authorized_official_last_name": "GRATIAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-529-1275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "G36443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G364430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Cardiology Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Pediatric Cardiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.