Provider Demographics
NPI:1265717953
Name:ROBERT MCGRAW APC
Entity type:Organization
Organization Name:ROBERT MCGRAW APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCGRAW
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:310-792-3914
Mailing Address - Street 1:210 N TUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3807
Mailing Address - Country:US
Mailing Address - Phone:714-347-1010
Mailing Address - Fax:714-647-1245
Practice Address - Street 1:25405 HANCOCK AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5982
Practice Address - Country:US
Practice Address - Phone:951-698-4670
Practice Address - Fax:951-698-4675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA111661207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADV3703Medicare PIN
CAFY304BMedicare PIN
CAFY304AMedicare PIN