Individual
PAUL CHARLES GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 WELCH RD, PALO ALTO, CA 94304-1601
(650) 497-8000
Mailing address
300 PASTEUR DR, G306, MC5208, STANFORD, CA 94305-2200
(650) 723-7903
(650) 498-6714
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A44616
CA
2080P0210X
Pediatric Nephrology Physician
Primary
A44616
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A446160
MEDI-CAL PROVIDER
CA
01
—
A44616
CALIFORNIA MEDICAL LICENS
CA
Enumeration date
10/17/2006
Last updated
04/16/2024
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