Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | A136035 | CA |
Y | 2086X0206X | Surgical Oncologist | A136035 | CA |
NPI | 1265866487 |
---|---|
Provider Name | Monica Grova |
First Address | Los Altos, CA 94022-1408 |
Second Address | Burlingame, CA 94010-4506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2013 |
Last Update Date | 05/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RES000 | (02) | CA |