Grant, Sophia R
Grant, Sophia R is an individual health care provider with primary practice located at 26520 Cactus Ave , Moreno Valley CA 92555-3927. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Child Abuse Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Grant, Sophia R can be contacted via phone (951) 486-4345.Contact Information
Primary practice address
26520 Cactus Ave
Moreno Valley CA 92555-3927
Phone: (951) 486-4345
Fax: (951) 486-4330
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | A66209 | California |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 207PP0204X | N6326 | Texas |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 24883 | Oklahoma |
| Allopathic & Osteopathic Physicians / Child Abuse Pediatrics | 2080C0008X | A66209 | California |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | A66209 | California |
Profile Details
| NPI number | 1841215613 |
|---|---|
| LBN Legal business name | Grant, Sophia R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 13th, 2006 |
| Last updated | Jun 7th, 2021 - about 5 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 | 1841215613 | NPPES |
| Oklahoma | MEDICAID | 200089650A | |
| Oklahoma | MEDICAID | 213341503 | |
| Oklahoma | Other | 213341504 |
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