Individual
MICHAEL GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
625 LINCOLN AVE, SAN JOSE, CA 95126-3785
(408) 871-5260
(408) 871-3237
Mailing address
400 RACE ST, SAN JOSE, CA 95126-3518
(408) 278-3000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA11821
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0PA118210
—
CA
Enumeration date
08/30/2006
Last updated
11/30/2020
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