Dr Laura Grunbaum, MD | |
1300 Bancroft Ave, Suite 204, San Leandro, CA 94577-5147 | |
(510) 483-2600 | |
Not Available |
Full Name | Dr Laura Grunbaum |
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Gender | Female |
Speciality | Pediatrics |
Location | 1300 Bancroft Ave, San Leandro, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780624700 | NPI | - | NPPES |
YYY48935Y | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | G080985 (California) | Primary |
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Mailing Address | Practice Location Address |
---|---|
Dr Laura Grunbaum, MD 66 Shannon Cir, Alameda, CA 94502-7729 Ph: (510) 435-0581 | Dr Laura Grunbaum, MD 1300 Bancroft Ave, Suite 204, San Leandro, CA 94577-5147 Ph: (510) 483-2600 |
Sharon Eileen Durousseau, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2500 Merced St, San Leandro, CA 94577 Phone: 510-454-1000 | |
Shannon Liu-ku, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2500 Merced Street, Hospital Building, Nicu, San Leandro, CA 94577 Phone: 510-454-1000 | |
Stacie Louise Walton, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2500 Merced St, San Leandro, CA 94577 Phone: 510-454-1000 | |
Dr. Arnold J Blustein, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1235 Harrison St, San Leandro, CA 94577 Phone: 510-352-2425 Fax: 510-352-6273 | |
Berenice M Ku, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2500 Merced St, San Leandro, CA 94577 Phone: 510-454-1000 | |
Dr. Roxanna Aimee Martinez, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2500 Merced St, San Leandro, CA 94577 Phone: 510-454-1000 Fax: 510-547-2702 | |
Dr. Katherine M Gallagher, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1555 Doolittle Drive, Bancroft Pediatrics, San Leandro, CA 94577 Phone: 510-483-2600 |