Individual
ROBERT K GRAY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2202 WILSHIRE BLVD, SANTA MONICA, CA 90403-5706
(310) 264-9000
(310) 264-9004
Mailing address
PO BOX 48904, LOS ANGELES, CA 90048-0904
(323) 297-0670
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G12388
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G123880
BLUE SHIELD OF CA
CA
05
—
00G123880
—
CA
Enumeration date
06/01/2006
Last updated
07/08/2007
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