Provider Demographics
NPI:1558650051
Name:GRAW, GRACE JANE (MD)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:JANE
Last Name:GRAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 EL CAMINO REAL STE F
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1000
Mailing Address - Country:US
Mailing Address - Phone:650-325-2530
Mailing Address - Fax:650-325-3226
Practice Address - Street 1:1515 EL CAMINO REAL STE F
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1000
Practice Address - Country:US
Practice Address - Phone:650-325-2530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122414208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery