Individual
RICHARD MARTIN GRANDQUIST III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
400 N PEPPER AVE STE 107, COLTON, CA 92324-1801
(650) 996-8240
Mailing address
349 MARTENS AVE, MOUNTAIN VIEW, CA 94040-3222
(650) 996-8240
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
51840
CA
Other
Enumeration date
08/20/2014
Last updated
08/20/2014
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