Basic Information
| Provider Information | |||||||||
| NPI: | 1811150345 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRABOWSKI | ||||||||
| FirstName: | JULIA | ||||||||
| MiddleName: | ELAINE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2160 S 1ST AVE | ||||||||
| Address2: | |||||||||
| City: | MAYWOOD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601533328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7082169000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3030 CHILDRENS WAY | ||||||||
| Address2: | STE #107 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921234232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8589667711 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2008 | ||||||||
| LastUpdateDate: | 08/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | A91515 | CA | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0120X | 036136923 | IL | Y | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery | 2086S0120X | A91515 | CA | N | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery |
No ID Information.