Grandaw, Peter Percy
Grandaw, Peter Percy is an sole proprietor health care provider with primary practice located at 1892 Buenaventura Blvd , Redding CA 96001-3761. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Grandaw, Peter Percy can be contacted via phone (530) 243-9478.Contact Information
Primary practice address
1892 Buenaventura Blvd
Redding CA 96001-3761
Phone: (530) 243-9478
Fax: (530) 243-9378
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | G79712 | California |
Profile Details
| NPI number | 1013900737 |
|---|---|
| LBN Legal business name | Grandaw, Peter Percy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 28th, 2005 |
| Last updated | Dec 10th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013900737 | NPPES |
| California | MEDICAID | 00G797120 |
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