Provider Demographics
NPI:1689012908
Name:TASSA, GRACE MORGAN (MD)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:MORGAN
Last Name:TASSA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:435 N ROXBURY DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:435 N ROXBURY DR STE 400
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5006
Practice Address - Country:US
Practice Address - Phone:424-587-3818
Practice Address - Fax:310-742-3865
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-08
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA141472207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine