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General NPI Number Information
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NPI Number | 1770590820
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Entity Type | Individual
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Provider Name | GRANT LUNDIE M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 8700 BEVERLY BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-1804
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Country | US
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Telephone | 310-423-5841
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 WALT WHITMAN RD STE 300
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City | MELVILLE
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State | NY
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Zip | 11747-4300
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD60058186
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2017-01866
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | R7527
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A85262
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License Number State | CA
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