Grady, Elizabeth

Grady, Elizabeth is an individual health care provider with primary practice located at 222 W 39Th Ave , San Mateo CA 94403-4364. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Grady, Elizabeth can be contacted via phone (650) 573-2222.

Contact Information

Primary practice address
222 W 39Th Ave San Mateo CA 94403-4364
Phone: (650) 573-2222
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G79216 California

Profile Details

NPI number 1578634820
LBN Legal business name Grady, Elizabeth
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2006
Last updated Jul 8th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578634820 NPPES
California MEDICAID 00G792160

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