Grundy, David A

Grundy, David A is an individual health care provider with primary practice located at 1165 Montgomery Dr , Santa Rosa CA 95405-4801. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Grundy, David A can be contacted via phone (707) 546-3210.

Contact Information

Primary practice address
1165 Montgomery Dr Santa Rosa CA 95405-4801
Phone: (707) 546-3210
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 35076862 Ohio
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X C55843 California

Profile Details

NPI number 1902845597
LBN Legal business name Grundy, David A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Mar 26th, 2016 - about 10 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 1902845597 NPPES
Ohio MEDICAID 2350343
Ohio Other 000000363780
Ohio Other P00273888

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