Individual
DAVID A GRUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1165 MONTGOMERY DR, SANTA ROSA, CA 95405-4801
(707) 546-3210
Mailing address
1165 MONTGOMERY DR, SANTA ROSA, CA 95405-4801
(707) 546-3210
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35076862
OH
207P00000X
Emergency Medicine Physician
Primary
C55843
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000363780
BCBS
OH
05
—
2350343
—
OH
01
—
P00273888
RAILROAD MEDICARE
—
Enumeration date
06/06/2006
Last updated
03/26/2016
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