{"npi":"1801974977","type":"NPI-1","status":"active","name":{"display":"Kenneth Grullon MD","other":[],"first":"KENNETH","last":"GRULLON","middle":"E.","credential":"MD"},"specialty":{"primary_taxonomy":"207V00000X","primary_taxonomy_description":"Obstetrics & Gynecology","slug":"ob-gyn","schema_org_specialty":"Obstetric","all":[{"code":"207V00000X","description":"Obstetrics & Gynecology","primary":true,"state":"CA","license":"G76376"}]},"addresses":[{"purpose":"LOCATION","street_1":"3400 DELTA FAIR BLVD","city":"ANTIOCH","state":"CA","postal_code":"945094004","country_code":"US","phone":"9257795000"},{"purpose":"MAILING","street_1":"1800 HARRISON ST FL 7","city":"OAKLAND","state":"CA","postal_code":"946123466","country_code":"US","phone":"5106256262"}],"license":{"state":"CA","number":"G76376"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"00G763760","state":"CA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20101209001277","type_code":"14-16","type_desc":"PRACTITIONER - OBSTETRICS/GYNECOLOGY","state":"CA","pac_id":"5799821377"}]},"enumeration_date":"2006-11-02","last_updated":"2021-12-17","_meta":{"source":"NPPES","snapshot_date":"2021-12-17","doc_url":"https://findmynpi.com/api"}}