Grossman, Kenneth Randell
Grossman, Kenneth Randell is an individual health care provider with primary practice located at 580 Collins Dr , Merced CA 95348-3121. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Grossman, Kenneth Randell can be contacted via phone (209) 383-0989.Contact Information
Primary practice address
580 Collins Dr
Merced CA 95348-3121
Phone: (209) 383-0989
Fax: (209) 383-6836
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | G50711 | California |
Profile Details
| NPI number | 1184684672 |
|---|---|
| LBN Legal business name | Grossman, Kenneth Randell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 27th, 2006 |
| Last updated | Jul 6th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184684672 | NPPES |
| California | MEDICAID | GR0087430 |
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