Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | G22076 | CA |
NPI | 1871824110 |
---|---|
Provider Name | Dr. William Edwin Gray III |
First Address | Saratoga, CA 95070 |
Second Address | Saratoga, CA 95070 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2010 |
Last Update Date | 27/01/2010 |