Grossman, Michael

Grossman, Michael is an individual health care provider with primary practice located at 414 E San Bernardino Rd , Covina CA 91723-1704. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Grossman, Michael can be contacted via phone (626) 915-5181.

Contact Information

Primary practice address
414 E San Bernardino Rd Covina CA 91723-1704
Phone: (626) 915-5181
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X A22902 California

Profile Details

NPI number 1790713519
LBN Legal business name Grossman, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Oct 23rd, 2008 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790713519 NPPES
California MEDICAID 00A229020
California Other A22902

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