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Individual

MS. CRYSTAL ANN GRUND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
225 SAN ANTONIO RD, MOUNTAIN VIEW, CA 94040-1209
(650) 948-0807
(650) 948-3319
Mailing address
1691 THE ALAMEDA, SAN JOSE, CA 95126-2203
(408) 795-3619
(408) 287-0405

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA18026
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
FJ318Y
MEDICARE PTAN
CA
Enumeration date
11/16/2006
Last updated
09/21/2011
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